Provider Demographics
NPI:1205452836
Name:JENNA M. RICHARDS DO
Entity type:Organization
Organization Name:JENNA M. RICHARDS DO
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NATALIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MURRELL
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:859-624-2020
Mailing Address - Street 1:793 EASTERN BYP STE 110
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:KY
Mailing Address - Zip Code:40475-2425
Mailing Address - Country:US
Mailing Address - Phone:859-624-2020
Mailing Address - Fax:859-623-7362
Practice Address - Street 1:793 EASTERN BYP STE 110
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40475-2425
Practice Address - Country:US
Practice Address - Phone:888-732-4293
Practice Address - Fax:859-623-7362
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-19
Last Update Date:2020-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty