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NPI Code Detail

MEDICARE: CHERYL DIANA RICHIE

MEDICARE: CHERYL DIANA RICHIE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208600000XSurgery PhysicianR3251KY

General Provider Information

NPI Number : 1013275841
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHERYL DIANA RICHIE
Provider Business Mailing Address
First Line : 138 LEADER AVE
Second Line :
City : LEXINGTON
State : KY
Zip : 40508-3215
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 138 LEADER AVE
Second Line :
City : LEXINGTON
State : KY
Zip : 40508-3215
Country : US
Telephone Number : 859-323-5261
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/30/2012
Last Update Date : 02/04/2022

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Directions to “ CHERYL DIANA RICHIE ” Practice Location

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