Healthcare Provider Details

I. General information

NPI: 1962257089
Provider Name (Legal Business Name): RACHAEL NEWMAN AGACNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/22/2024
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1250 E MARSHALL ST
RICHMOND VA
23298-5023
US

IV. Provider business mailing address

1250 E MARSHALL ST
RICHMOND VA
23298-5023
US

V. Phone/Fax

Practice location:
  • Phone: 804-828-4620
  • Fax: 804-628-0537
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number0001274172
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number0024190801
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: