NPI | 1720422934 |
---|---|
Former Name | SHANNON K RICHMOND |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 95006341) |
Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 9506341) |
Enumeration Date | 2013-04-18 |
Last Update Date | 2023-11-13 |