Provider Demographics
NPI:1780045039
Name:RICH, SHENITA
Entity Type:Individual
Prefix:
First Name:SHENITA
Middle Name:
Last Name:RICH
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 1:171 CLARK RD
Mailing Address - Street 2:
Mailing Address - City:WARSAW
Mailing Address - State:VA
Mailing Address - Zip Code:22572-3447
Mailing Address - Country:US
Mailing Address - Phone:804-313-5373
Mailing Address - Fax:
Practice Address - Street 1:171 CLARK RD
Practice Address - Street 2:POST OFFICE BOX 53
Practice Address - City:WARSAW
Practice Address - State:VA
Practice Address - Zip Code:22572-3447
Practice Address - Country:US
Practice Address - Phone:804-313-5373
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-15
Last Update Date:2016-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide