Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 1-148479 | AL |
NPI | 1003422320 |
---|---|
Provider Name | Mrs. Leah York Richardson |
First Address | Tuscaloosa, AL 35405-7806 |
Second Address | Birmingham, AL 35249-1900 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/09/2020 |
Last Update Date | 05/06/2021 |