Organization
CENTERCARE FAMILY PRACTICE, LLC
Active
Other names
PEDSPLUS PRIMARY CARE
Organization subpart
No
Provider details
NPI number
Authorized official
MICKELINA LAURORE FNP (MANAGER)
(239) 691-5450
Entity
Organization
Contact information
Practice address
1300 EMANCIPATION HWY, FREDERICKSBURG, VA 22401-4600
(540) 289-2273
(540) 699-0214
Mailing address
1010 W KENSINGTON CIR, FREDERICKSBURG, VA 22401-8003
(239) 691-5450
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
VA
Other
Enumeration date
06/29/2016
Last updated
12/30/2022
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