Healthcare Provider Details

I. General information

NPI: 1588308985
Provider Name (Legal Business Name): RACHEL S SMITH NURSE PRACTITIONER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/22/2022
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4901 FITZHUGH AVE STE 200
RICHMOND VA
23230-3531
US

IV. Provider business mailing address

4901 FITZHUGH AVE STE 200
RICHMOND VA
23230-3531
US

V. Phone/Fax

Practice location:
  • Phone: 804-464-8340
  • Fax:
Mailing address:
  • Phone: 804-464-8340
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number0024183810
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: