Provider Demographics
NPI:1558957365
Name:RICHARD, JENAE ARMANI
Entity Type:Individual
Prefix:
First Name:JENAE
Middle Name:ARMANI
Last Name:RICHARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6907 ELLIS CT APT C
Mailing Address - Street 2:
Mailing Address - City:FORT POLK
Mailing Address - State:LA
Mailing Address - Zip Code:71459-3123
Mailing Address - Country:US
Mailing Address - Phone:719-289-2449
Mailing Address - Fax:
Practice Address - Street 1:6907 ELLIS CT APT C
Practice Address - Street 2:
Practice Address - City:FORT POLK
Practice Address - State:LA
Practice Address - Zip Code:71459-3123
Practice Address - Country:US
Practice Address - Phone:719-289-2449
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-15
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator