Individual
MR. JASON RICHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNP
Contact information
Practice address
805 E LEE ST, ENTERPRISE, AL 36330-2368
(334) 348-8818
(334) 393-8773
Mailing address
805 E LEE ST, ENTERPRISE, AL 36330-2368
(334) 348-8818
(334) 393-8773
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1-133901
AL
Other
Enumeration date
07/01/2015
Last updated
07/01/2015
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