Doctor Name: | MRS. NICOLE YVETTE RICHARDS |
NPI Number: | 1033302955 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP |
License Number: | 28134643A |
Business Practice Address: | 3900 Calhoun St Gary, IN - 464081753 |
Business Phone Number: | 2194842457 |
Business Fax Number: | 2199235418 |
Mailing Address: | 2259 Rutledge St, GARY |
State: | IN |
Postal Code: | 464043340 |
Phone Number: | 2196894739 |
Fax Number: | |
NPI Enumeration Date: | 08/23/2007 |
NPI Last Update Date: | 02/01/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 28134643A |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IN |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |