| NPI | 1255798823 |
|---|---|
| Former Name | PHYLICIA R RICHARDSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71006018A) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: IN 71006018A) |
| Enumeration Date | 2016-01-27 |
| Last Update Date | 2025-02-14 |