Individual
BIRDINE MILDRED-MARIE HERALD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
2100 ROANOKE ST STE 1, CHRISTIANSBURG, VA 24073-2512
(434) 941-6207
Mailing address
1941 CHARLEY BALLARD RD, LINDSIDE, WV 24951-7360
(304) 994-1262
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
0002061023
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0002061023
LPN
VA
Enumeration date
11/21/2021
Last updated
11/21/2021
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