Healthcare Provider Details

I. General information

NPI: 1427883255
Provider Name (Legal Business Name): ROSEWELL HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/03/2024
Last Update Date: 01/28/2026
Certification Date: 01/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8507 HAMPTON CROSSING PL
CHESTERFIELD VA
23832-2673
US

IV. Provider business mailing address

308 N 6TH AVE
HOPEWELL VA
23860-2518
US

V. Phone/Fax

Practice location:
  • Phone: 804-243-4239
  • Fax:
Mailing address:
  • Phone: 804-243-4239
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: AUGUSTINA U NYECHE
Title or Position: NP
Credential: NURSE PRACTITIONER
Phone: 804-243-4239