Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC1500X | Nurse Practitioner - Community Health | 200921 | NC |
NPI | 1720127814 |
---|---|
Provider Name | Betsy Richards |
First Address | Wilson, NC 27893-4105 |
Second Address | Wilson, NC 27893-4105 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/02/2007 |
Last Update Date | 08/07/2007 |