MEDICARE: JENNIFER P PEELE PMHNP-BC, FNP-BC

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	0024171004	VA
2	363LF0000X	Family Nurse Practitioner	0024171004	VA

General Provider Information

NPI Number	:	1619318870
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER P PEELE PMHNP-BC, FNP-BC

Provider Business Mailing Address
First Line	:	1933 HICKORYRIDGE RD
Second Line	:
City	:	HENRICO
State	:	VA
Zip	:	23238-3805
Country	:	US
Telephone Number	:	804-203-2348
Fax Number	:	840-788-5905

Provider Business Practice Location Address
First Line	:	5101 MONUMENT AVE STE 204
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23230-3253
Country	:	US
Telephone Number	:	804-203-2348
Fax Number	:	840-788-5905

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/16/2013
Last Update Date	:	11/20/2025

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