Organization · Type 2 NPI

Ketavia

Psychiatric/Mental Health Nurse Practitioner · Midlothian, VA

NPI number 1629936703 Active

Practice location

5309 Commonwealth Centre Pkwy Ste 105
Midlothian, VA 23112-2633

Call (804) 940-8959 Map

Fax (804) 308-3362

Mailing address

5309 Commonwealth Centre Pkwy Ste 103
Midlothian, VA 23112-2633

Specialties and licenses

TaxonomyCodeLicense
Psychiatric/Mental Health Nurse Practitioner Primary 363LP0808XNone listed

Psychiatric/Mental Health Nurse Practitioner: Definition to come...

2 other providers at this address

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About NPI 1629936703

Ketavia's National Provider Identifier is 1629936703, issued on Jan 15, 2026. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Midlothian, VA. The record was last updated on Jan 19, 2026.