Organization
MINERVA HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NAOMI AYLESWORTH (AUTHORIZED OFFICIAL)
(804) 464-8412
Entity
Organization
Contact information
Practice address
2300 CEDARFIELD PKWY, RICHMOND, VA 23233-1936
(804) 464-8412
Mailing address
PO BOX 2516, MIDLOTHIAN, VA 23113-8516
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
11/20/2018
Last updated
11/05/2024
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