MEDICARE: BRIGHT SKY PSYCHIATRY, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1447110010
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRIGHT SKY PSYCHIATRY, PLLC

Provider Business Mailing Address
First Line	:	5412 GLENSIDE DR STE B
Second Line	:
City	:	HENRICO
State	:	VA
Zip	:	23228-3995
Country	:	US
Telephone Number	:	804-251-3364
Fax Number	:	804-999-0452

Provider Business Practice Location Address
First Line	:	5412 GLENSIDE DR STE B
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23228-3995
Country	:	US
Telephone Number	:	804-251-3364
Fax Number	:	804-999-0452

Authorized Official
Title or Position	:	OWNER
Name	:	KATE TUCKER TIBBS
Credential	:	PMHNP
Telephone Number	:	804-251-3364

Provider Enumeration Date	:	11/14/2025
Last Update Date	:	02/02/2026

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