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General NPI Number Information
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NPI Number | 1962824615
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Entity Type | Individual
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Provider Name | JACQUELINE BOONE AGACNP-BC, PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 01/15/2014
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Last Update Date | 01/21/2026
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Provider Practice Location Address
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Address Line | 3751 NINE MILE RD
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City | RICHMOND
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State | VA
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Zip | 23223-4830
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Country | US
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Telephone | 804-492-7263
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Fax | 804-220-5253
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Provider Business Mailing Address
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Address Line | 14321 WINTER BREEZE DR STE 67
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City | MIDLOTHIAN
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State | VA
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Zip | 23113-2452
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Country | US
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Telephone |
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 0024175120
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 0024175120
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License Number State | VA
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