MEDICARE: MS. JAMIE HARRELL RICHARDS CRNA

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
1	367500000X	Certified Registered Nurse Anesthetist	RN-178397083029CRNA	NC

General Provider Information

NPI Number	:	1285957209
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JAMIE HARRELL RICHARDS CRNA

Provider Business Mailing Address
First Line	:	2700 WAYNE MEMORIAL DRIVE
Second Line	:
City	:	GOLDSBORO
State	:	NC
Zip	:	27534-9459
Country	:	US
Telephone Number	:	919-731-6068
Fax Number	:	919-731-6025

Provider Business Practice Location Address
First Line	:	2700 WAYNE MEMORIAL DRIVE
Second Line	:
City	:	GOLDSBORO
State	:	NC
Zip	:	27534-9459
Country	:	US
Telephone Number	:	919-731-6068
Fax Number	:	919-731-6025

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/04/2010
Last Update Date	:	03/04/2010

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