DIANE K RICHARDSON

GRANDVILLE, MI
NPI1093781858
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: MI  4704110245)
Enumeration Date2006-02-23
Last Update Date2011-10-03
Business Address
-- DIANE K RICHARDSON NP
141 PORT SHELDON RD SW
GRANDVILLE, MI 49418-2149
Phone number: 616-235-2090
Mailing Address
-- DIANE K RICHARDSON NP
PO BOX 1767
GRAND RAPIDS, MI 49501-1767
Phone number: 616-235-2090