Healthcare Provider Details

I. General information

NPI: 1699547117
Provider Name (Legal Business Name): REBEKAH HAMLETT FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/27/2023
Last Update Date: 09/12/2026
Certification Date: 09/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1122 N 25TH ST
RICHMOND VA
23223-5254
US

IV. Provider business mailing address

4191 INNSLAKE DR STE 212
GLEN ALLEN VA
23060-3324
US

V. Phone/Fax

Practice location:
  • Phone: 804-508-6045
  • Fax:
Mailing address:
  • Phone: 804-303-9622
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024197383
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: