Healthcare Provider Details

I. General information

NPI: 1083541874
Provider Name (Legal Business Name): HATTIE WINFIELD AGPCNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/06/2026
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

517 W GRACE ST
RICHMOND VA
23220-4911
US

IV. Provider business mailing address

517 W GRACE ST
RICHMOND VA
23220-4911
US

V. Phone/Fax

Practice location:
  • Phone: 804-783-2505
  • Fax: 804-649-1635
Mailing address:
  • Phone: 804-783-2505
  • Fax: 804-649-1635

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number0024197148
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: