Individual
JEANISE RICHARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
6 HERITAGE LN, BALLSTON SPA, NY 12020-2715
(518) 884-2670
Mailing address
6 HERITAGE LN, BALLSTON SPA, NY 12020-2715
(518) 884-2670
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
372604
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
372604
RN LICENSE
NY
Enumeration date
05/08/2007
Last updated
07/28/2014
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