Healthcare Provider Details

I. General information

NPI: 1467260901
Provider Name (Legal Business Name): ADENIKE ABDULRAHEEM PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/30/2024
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2125 HILLIARD RD
RICHMOND VA
23228-4600
US

IV. Provider business mailing address

1 N 5TH ST STE 403
RICHMOND VA
23219-2232
US

V. Phone/Fax

Practice location:
  • Phone: 804-429-9053
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number0024192182
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: