Healthcare Provider Details

I. General information

NPI: 1518217991
Provider Name (Legal Business Name): TAMMY D KING-KNIGHTEN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2012
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3908 NINE MILE RD
RICHMOND VA
23223-4913
US

IV. Provider business mailing address

3908 NINE MILE RD
RICHMOND VA
23223-4913
US

V. Phone/Fax

Practice location:
  • Phone: 804-727-8100
  • Fax: 804-727-8100
Mailing address:
  • Phone: 804-727-8517
  • Fax: 804-727-8580

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number0001164833
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number0024195513
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: