Provider Demographics
NPI:1346280393
Name:JENNINGS, RICHARD FRANCIS (CNM)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:FRANCIS
Last Name:JENNINGS
Suffix:
Gender:M
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 YORK ST
Mailing Address - Street 2:LABOR & DELIVERY YALE NEW HAVEN HOSPITAL, WP-4
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06510-3220
Mailing Address - Country:US
Mailing Address - Phone:203-688-2309
Mailing Address - Fax:
Practice Address - Street 1:20 YORK ST
Practice Address - Street 2:LABOR & DELIVERY YALE NEW HAVEN HOSPITAL, WP-4
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06510-3220
Practice Address - Country:US
Practice Address - Phone:203-688-2309
Practice Address - Fax:203-785-6455
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2011-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF000957176B00000X
CT366367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYMEM101Medicare PIN