Healthcare Provider Details

I. General information

NPI: 1891617973
Provider Name (Legal Business Name): JESSICA RICHMOND RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JESSICA DREWS RN

II. Dates (important events)

Enumeration Date: 07/29/2026
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 MERCURY VILLAGE DR STE 115
DURANGO CO
81301-8955
US

IV. Provider business mailing address

150 MERCURY VILLAGE DR STE 115
DURANGO CO
81301-8955
US

V. Phone/Fax

Practice location:
  • Phone: 970-828-8850
  • Fax: 970-247-9126
Mailing address:
  • Phone: 970-828-8843
  • Fax: 970-247-9126

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number14-154251-121
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: