Richardson, Virginia

Richardson, Virginia is an individual health care provider with primary practice located at 3401 E Raymond St , Indianapolis IN 46203-4744. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Richardson, Virginia can be contacted via phone (317) 788-9769.

Contact Information

Primary practice address
3401 E Raymond St Indianapolis IN 46203-4744
Phone: (317) 788-9769
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X 28050697 Indiana

Profile Details

NPI number 1578514006
LBN Legal business name Richardson, Virginia
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date May 12th, 2006
Last updated Sep 8th, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1578514006 NPPES
Indiana MEDICAID 200025100

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