Provider Demographics
NPI:1578275939
Name:ANN VIRGINIA HOME CARE AGENCY, LLC
Entity Type:Organization
Organization Name:ANN VIRGINIA HOME CARE AGENCY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF FAMILY NURSE PRACTITIONER
Authorized Official - Prefix:DR
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:
Authorized Official - Last Name:MCLEOD
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, FNP
Authorized Official - Phone:919-638-2084
Mailing Address - Street 1:1215 E POINTE DR
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27712-9488
Mailing Address - Country:US
Mailing Address - Phone:919-381-5504
Mailing Address - Fax:919-381-5504
Practice Address - Street 1:1215 E POINTE DR
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27712-9488
Practice Address - Country:US
Practice Address - Phone:919-381-5504
Practice Address - Fax:919-381-5504
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-16
Last Update Date:2022-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care