Healthcare Provider Details

I. General information

NPI: 1215856117
Provider Name (Legal Business Name): SAMANTHA SERIO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2026
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2819 N PARHAM RD STE 130
RICHMOND VA
23294-4425
US

IV. Provider business mailing address

2819 N PARHAM RD STE 130
RICHMOND VA
23294-4425
US

V. Phone/Fax

Practice location:
  • Phone: 804-924-7600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number0024198079
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: