Healthcare Provider Details

I. General information

NPI: 1255269668
Provider Name (Legal Business Name): BETTY N/A OSSAI SR.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/13/2026
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1907 ENON STATION DR
CHESTER VA
23836-3313
US

IV. Provider business mailing address

1907 ENON STATION DR
CHESTER VA
23836-3313
US

V. Phone/Fax

Practice location:
  • Phone: 804-966-2242
  • Fax: 804-966-5639
Mailing address:
  • Phone: 804-966-2242
  • Fax: 804-966-5639

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberF408190-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: