Healthcare Provider Details

I. General information

NPI: 1831018282
Provider Name (Legal Business Name): B W INNOVATIVE AFFILIATE SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2026
Last Update Date: 07/10/2026
Certification Date: 06/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

359 LAUREL DRIVE
AYLETT VA
23009
US

IV. Provider business mailing address

6841 FOREST HILL AVE # 455
RICHMOND VA
23225-1603
US

V. Phone/Fax

Practice location:
  • Phone: 804-258-1300
  • Fax: 804-259-1307
Mailing address:
  • Phone: 804-258-1300
  • Fax: 804-259-1307

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: BRITTEN WHITE
Title or Position: CEO/OWNER
Credential: DNP, FNP-C, PMHNP-BC
Phone: 804-258-1300