Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | R3251 | KY |
Y | 208600000X | Surgeon | R3251 | KY |
NPI | 1013275841 |
---|---|
Provider Name | Cheryl Diana Richie |
First Address | Lexington, KY 40508-3215 |
Second Address | Lexington, KY 40508-3215 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/04/2012 |
Last Update Date | 04/02/2022 |