KETAVIA NPI 1629936703

NPI Information

  • NPI: 1629936703
  • Provider Name: KETAVIA
  • Classification: Nurse Practitioner - 363LP0808X
  • Specialization: Psychiatric/Mental Health
  • Entity Type: Organization
  • Address: 5309 COMMONWEALTH CENTRE PKWY STE 105
    MIDLOTHIAN, VA
    ZIP 23112
  • Phone: (804) 940-8959

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NPI Details

KETAVIA is a psychiatric/mental health nurse practitioner in Midlothian, VA. KETAVIA NPI is 1629936703. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

5309 COMMONWEALTH CENTRE PKWY STE 105
MIDLOTHIAN, VA
ZIP 23112-633
Phone: (804) 940-8959
Fax: (804) 308-3362

The provider's authorized official is Keisha Lopez .
The authorized official title is Owner and has the following contact phone number (804) 308-3403.

The enumeration date for this NPI number is 1/15/2026 and was last updated on 1/19/2026.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LP0808XNurse PractitionerPsychiatric/Mental HealthYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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