Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PE0004X | Emergency Medical Services | 1-121230 | AL |
NPI | 1013661180 |
---|---|
Provider Name | Nikeya Betts Richardson |
First Address | Repton, AL 36475-3014 |
Second Address | Bay Minette, AL 36507-4110 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/02/2022 |
Last Update Date | 09/02/2022 |