Healthcare Provider Details

I. General information

NPI: 1316713662
Provider Name (Legal Business Name): JESSICA MORGAN EAMES PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/28/2023
Last Update Date: 09/23/2024
Certification Date: 09/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

302 TURNER RD STE JANDK
NORTH CHESTERFIELD VA
23225-6433
US

IV. Provider business mailing address

302 TURNER RD STE JANDK
NORTH CHESTERFIELD VA
23225-6433
US

V. Phone/Fax

Practice location:
  • Phone: 804-901-4430
  • Fax:
Mailing address:
  • Phone: 804-901-4430
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number0024186825
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: