Birdine Mildred-Marie Herald, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

0002061023 Issued in VA

Practice address

2100 Roanoke St Ste 1
Christiansburg, VA 24073-2512

Phone

(434) 941-6207

NPI assigned

Nov 21, 2021

Last updated

Nov 21, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1637452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637452800000",
    "number": "1457018749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1941 CHARLEY BALLARD RD",
            "city": "LINDSIDE",
            "state": "WV",
            "postal_code": "249517360",
            "telephone_number": "304-994-1262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 ROANOKE ST STE 1",
            "city": "CHRISTIANSBURG",
            "state": "VA",
            "postal_code": "240732512",
            "telephone_number": "434-941-6207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERALD",
        "first_name": "BIRDINE",
        "middle_name": "MILDRED-MARIE",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-21",
        "last_updated": "2021-11-21",
        "certification_date": "2021-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "VA",
            "license": "0002061023",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LPN",
            "identifier": "0002061023",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Licensed Practical Nurse in Christiansburg, VA
• Providers in Christiansburg, VA by specialty
• Licensed Practical Nurse in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.