Healthcare Provider Details

I. General information

NPI: 1316989866
Provider Name (Legal Business Name): RICHMOND WOMEN'S HEALTH CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2006
Last Update Date: 02/14/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

795 EASTERN BYP BUILDING 2, SUITE 5
RICHMOND KY
40475-2406
US

IV. Provider business mailing address

795 EASTERN BYP BUILDING 2, SUITE 5
RICHMOND KY
40475-2406
US

V. Phone/Fax

Practice location:
  • Phone: 859-624-2229
  • Fax: 859-625-9458
Mailing address:
  • Phone: 859-624-2229
  • Fax: 859-625-9458

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number2048M
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number StateKY

VIII. Authorized Official

Name: GINA L. LAND
Title or Position: CEO/PHYSICIAN
Credential: M.D.
Phone: 859-624-2229