Doctor Name: | DR. NANCY RICHARDSON |
NPI Number: | 1629081484 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.D. |
License Number: | 24373 |
Business Practice Address: | 3400 W 66th St Suite 140 Edina, MN - 554352111 |
Business Phone Number: | 9253453000 |
Business Fax Number: | |
Mailing Address: | 16460 45th Ave N, PLYMOUTH |
State: | MN |
Postal Code: | 554462048 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 08/14/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 24373 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |