Provider Demographics
NPI:1285886424
Name:DENVER FAMILY HEALTHCARE,PLLC
Entity type:Organization
Organization Name:DENVER FAMILY HEALTHCARE,PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/FAMILY NURSE PRACTITIONER
Authorized Official - Prefix:MRS
Authorized Official - First Name:VIRGINIA
Authorized Official - Middle Name:B
Authorized Official - Last Name:ERVIN
Authorized Official - Suffix:
Authorized Official - Credentials:MSN, FNP-BC
Authorized Official - Phone:704-739-5550
Mailing Address - Street 1:108 W MOUNTAIN ST
Mailing Address - Street 2:
Mailing Address - City:KINGS MOUNTAIN
Mailing Address - State:NC
Mailing Address - Zip Code:28086-3413
Mailing Address - Country:US
Mailing Address - Phone:704-739-5550
Mailing Address - Fax:800-317-3563
Practice Address - Street 1:108 W MOUNTAIN ST
Practice Address - Street 2:
Practice Address - City:KINGS MOUNTAIN
Practice Address - State:NC
Practice Address - Zip Code:28086-3413
Practice Address - Country:US
Practice Address - Phone:704-739-5550
Practice Address - Fax:800-317-3563
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-21
Last Update Date:2013-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
2592397AOtherMEDICARE PTAN