Healthcare Provider Details

I. General information

NPI: 1568252922
Provider Name (Legal Business Name): KOMALPREET KAUR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/08/2025
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8804 PATTERSON AVE
RICHMOND VA
23229-6361
US

IV. Provider business mailing address

4901 STABLE RIDGE CT
GLEN ALLEN VA
23059-2648
US

V. Phone/Fax

Practice location:
  • Phone: 804-592-6311
  • Fax: 844-744-0273
Mailing address:
  • Phone: 703-593-6739
  • Fax: 844-744-0273

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number24193479
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: