Healthcare Provider Details

I. General information

NPI: 1497462634
Provider Name (Legal Business Name): TOPE JOSEPHINE OLADIMEJI DNP, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/27/2022
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2819 N PARHAM RD STE 120
HENRICO VA
23294-4425
US

IV. Provider business mailing address

3624 SPRATLING WAY
NORTH CHESTERFIELD VA
23237-1954
US

V. Phone/Fax

Practice location:
  • Phone: 804-293-3640
  • Fax: 804-870-9628
Mailing address:
  • Phone: 501-442-4928
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number0024185635
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: