Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 2673 | MN |
N | 363L00000X | Nurse Practitioner | R116351-9 | MN |
N | 363LA2100X | Nurse Practitioner - Acute Care | 2673 | MN |
NPI | 1023418506 |
---|---|
Provider Name | Diane Richardson |
First Address | Rochester, MN 55905-0001 |
Second Address | Rochester, MN 55905-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/09/2014 |
Last Update Date | 05/10/2020 |