Healthcare Provider Details
I. General information
NPI: 1124849567
Provider Name (Legal Business Name): YOU ARE AMAZING HEALTH AND WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/18/2024
Last Update Date: 07/02/2025
Certification Date: 06/13/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5033 SELWOOD RD
RICHMOND VA
23234
US
IV. Provider business mailing address
1601 WILLOW LAWN DR STE 304
RICHMOND VA
23230-3423
US
V. Phone/Fax
- Phone: 804-878-3518
- Fax:
- Phone: 804-878-3518
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RA0401X |
| Taxonomy | Addiction Medicine (Internal Medicine) Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
HANNAH
BRAXTON
Title or Position: OWNER
Credential: NP
Phone: 804-592-6606