Doctor Name: | LISA B RICHARDSON |
NPI Number: | 1427072750 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FAMILY NURSE PRACTIT |
License Number: | F332977-1 |
Business Practice Address: | 55 Joy Dr Loudonville, NY - 122111539 |
Business Phone Number: | 5184697588 |
Business Fax Number: | |
Mailing Address: | 55 Joy Dr, LOUDONVILLE |
State: | NY |
Postal Code: | 122111539 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 07/27/2006 |
NPI Last Update Date: | 04/16/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | F332977-1 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |