Healthcare Provider Details

I. General information

NPI: 1043023948
Provider Name (Legal Business Name): PEYTON MACKENZIE MABINS APRN, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2025
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

382 TAYLOR DR
DANVILLE VA
24541-4023
US

IV. Provider business mailing address

382 TAYLOR DR
DANVILLE VA
24541-4023
US

V. Phone/Fax

Practice location:
  • Phone: 434-799-6220
  • Fax:
Mailing address:
  • Phone: 434-799-6220
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number0024197182
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number0001287939
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: