MEDICARE: DR. ANNA KAITLYN RICH DNP, APRN, FNP-C

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	363LF0000X	Family Nurse Practitioner	APRN11013700	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1801464789
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANNA KAITLYN RICH DNP, APRN, FNP-C

Provider Business Mailing Address
First Line	:	4205 BELFORT RD STE 4015
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32216-3623
Country	:	US
Telephone Number	:	904-450-6063
Fax Number	:	904-539-4091

Provider Business Practice Location Address
First Line	:	805 HIGHWAY 22
Second Line	:
City	:	WEWAHITCHKA
State	:	FL
Zip	:	32465-3237
Country	:	US
Telephone Number	:	850-568-1053
Fax Number	:	850-568-1140

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

Provider Enumeration Date	:	06/16/2021
Last Update Date	:	04/14/2022

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