Healthcare Provider Details

I. General information

NPI: 1164372983
Provider Name (Legal Business Name): JESSICA KNOX HAINES PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JESSICA KNOX HAINES PMHNP

II. Dates (important events)

Enumeration Date: 01/31/2026
Last Update Date: 03/12/2026
Certification Date: 03/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2301 N PARHAM RD STE 5
RICHMOND VA
23229-3171
US

IV. Provider business mailing address

5101 OLD MAIN ST APT 335
HENRICO VA
23231-3012
US

V. Phone/Fax

Practice location:
  • Phone: 804-270-1124
  • Fax:
Mailing address:
  • Phone: 985-249-4146
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number24196224
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: