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NPI Code Detail

MEDICARE: JASON RICHARD APRN

MEDICARE: JASON RICHARD APRN
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
1363LA2100XAcute Care Nurse Practitioner21355SC
2363LF0000XFamily Nurse Practitioner21355SC
3363L00000XNurse Practitioner21355SC

General Provider Information

NPI Number : 1841747417
Entity Type Code : Individual
Provider Name (Legal Business Name) : JASON RICHARD APRN
Provider Business Mailing Address
First Line : 2817 ROCK MERRITT AVE
Second Line :
City : FORT BRAGG
State : NC
Zip : 28310-0001
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2817 ROCK MERRITT AVE
Second Line :
City : FORT BRAGG
State : NC
Zip : 28310-0001
Country : US
Telephone Number : 910-907-8922
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/01/2016
Last Update Date : 12/23/2025

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