Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2200X | Nurse Practitioner - Adult Health | AP3313 | AZ |
Y | 363LP0200X | Nurse Practitioner - Pediatrics | AP3376 | AZ |
NPI | 1023072519 |
---|---|
Provider Name | Mr. Galen Francis Richmond |
First Address | Prescott, AZ 86301-5856 |
Second Address | Prescott, AZ 86305-3700 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/04/2006 |
Last Update Date | 10/08/2018 |