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General NPI Number Information
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NPI Number | 1427869528
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Entity Type | Individual
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Provider Name | NIA IMANI DENNIS
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Gender | Female
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Dates
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Enumeration Date | 01/17/2025
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Last Update Date | 01/17/2025
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Provider Practice Location Address
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Address Line | 5706 GROVE AVE
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City | RICHMOND
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State | VA
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Zip | 23226-2343
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Country | US
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Telephone | 804-325-4795
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Fax |
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Provider Business Mailing Address
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Address Line | 6540 CARTERS WALK LN
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City | NORTH CHESTERFIELD
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State | VA
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Zip | 23234-6345
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Country | US
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Telephone | 804-429-9102
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 24192332
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License Number State | VA
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