Healthcare Provider Details

I. General information

NPI: 1407812811
Provider Name (Legal Business Name): JENNIFER C SCHRECENGOST PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2006
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10900 NUCKOLS RD STE 100
GLEN ALLEN VA
23060-9277
US

IV. Provider business mailing address

10900 NUCKOLS RD STE 100
GLEN ALLEN VA
23060-9277
US

V. Phone/Fax

Practice location:
  • Phone: 804-207-6737
  • Fax:
Mailing address:
  • Phone: 804-207-6737
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number0024165938
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number0001177869
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: