| NPI | 1831442367 |
|---|---|
| Former Name | CHARLENE ANN RICHARDSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MT NUR-APRN-LIC-100414) |
| Enumeration Date | 2012-10-22 |
| Last Update Date | 2024-04-05 |