MEDICARE: ANGELA RICHARDSON MS, RDN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133V00000X	Registered Dietitian	86167930	AZ

General Provider Information

NPI Number	:	1891443875
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELA RICHARDSON MS, RDN

Provider Business Mailing Address
First Line	:	345 BANNOCK ST
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80524-3647
Country	:	US
Telephone Number	:	720-600-1611
Fax Number	:

Provider Business Practice Location Address
First Line	:	345 BANNOCK ST
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80524-3647
Country	:	US
Telephone Number	:	720-600-1611
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/17/2022
Last Update Date	:	09/14/2025

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