Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | ARNP9269226 | FL |
NPI | 1003291923 |
---|---|
Provider Name | Jennifer Richards |
First Address | Miramar, FL 33025-3946 |
Second Address | Miramar, FL 33025-3946 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2015 |
Last Update Date | 30/03/2021 |