Healthcare Provider Details

I. General information

NPI: 1962780973
Provider Name (Legal Business Name): TESSA DEYLE PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2011
Last Update Date: 08/14/2025
Certification Date: 08/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 BROAD ROCK BLVD
RICHMOND VA
23224-4915
US

IV. Provider business mailing address

1201 BROAD ROCK BLVD
RICHMOND VA
23249-4915
US

V. Phone/Fax

Practice location:
  • Phone: 804-675-5000
  • Fax:
Mailing address:
  • Phone: 804-675-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835C0205X
TaxonomyCritical Care Pharmacist
License NumberS018501
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: