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Individual

DR. KINIYA CHANTERA CHURCH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DNP, FNP-C, PMHNP-BC

Contact information

Practice address
14321 WINTER BREEZE DR, MIDLOTHIAN, VA 23113-2452
(833) 452-9772
(888) 442-6953
Mailing address
22 CROATAN TRL, PORTSMOUTH, VA 23701-2416
(757) 938-0140

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
0024171501
VA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
0024171501
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
C04555
GROUP PTAN
VA
01
C05149
GROUP PTAN
VA
01
C05403
GROUP PTAN
VA
01
GC1103
GROUP PTAN
VA
Enumeration date
02/24/2014
Last updated
04/29/2026
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