Provider Demographics
NPI:1124733159
Name:ANDERSON, LENEKA N (CNM)
Entity type:Individual
Prefix:MRS
First Name:LENEKA
Middle Name:N
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7603 FOREST AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23229-4942
Mailing Address - Country:US
Mailing Address - Phone:804-523-3712
Mailing Address - Fax:
Practice Address - Street 1:7603 FOREST AVE STE 207
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23229-4937
Practice Address - Country:US
Practice Address - Phone:804-523-3712
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-13
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001284982163W00000X
VA0024186240367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No163W00000XNursing Service ProvidersRegistered Nurse