Healthcare Provider Details

I. General information

NPI: 1972433167
Provider Name (Legal Business Name): JADE RICHMOND RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/20/2026
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5402 FIESTA OAK DR
KILLEEN TX
76542-6347
US

IV. Provider business mailing address

5402 FIESTA OAK DR
KILLEEN TX
76542-6347
US

V. Phone/Fax

Practice location:
  • Phone: 254-350-4999
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number1100881
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: