Individual
JENETT C. RICHARDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
8175 NW 12TH ST, SUITE 306, DORAL, FL 33126-1828
(786) 845-0173
(786) 845-0176
Mailing address
8175 NW 12TH ST, SUITE 306, DORAL, FL 33126-1828
(786) 845-0173
(786) 845-0176
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
ARNP617492
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0279234
—
FL
Enumeration date
05/07/2007
Last updated
07/09/2007
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