Healthcare Provider Details

I. General information

NPI: 1265462782
Provider Name (Legal Business Name): JOYNITA R. NICHOLSON D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JOYNITA M. ROBINSON D.O.

II. Dates (important events)

Enumeration Date: 07/03/2006
Last Update Date: 04/16/2025
Certification Date: 04/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7864 RICHMOND TAPPAHANNOCK HWY
AYLETT VA
23009-3056
US

IV. Provider business mailing address

3810 W BROAD ST STE 104
RICHMOND VA
23230-3927
US

V. Phone/Fax

Practice location:
  • Phone: 804-769-2015
  • Fax: 804-769-2014
Mailing address:
  • Phone: 804-655-6008
  • Fax: 833-428-7575

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0102201532
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: