Individual
JASON RICHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
2817 ROCK MERRITT AVE, FORT BRAGG, NC 28310-0001
(910) 907-8922
Mailing address
2817 ROCK MERRITT AVE, FORT BRAGG, NC 28310-0001
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
21355
SC
363LA2100X
Acute Care Nurse Practitioner
21355
SC
363LF0000X
Family Nurse Practitioner
Primary
21355
SC
Other
Enumeration date
09/01/2016
Last updated
12/23/2025
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