Healthcare Provider Details

I. General information

NPI: 1518854363
Provider Name (Legal Business Name): NATALIA RICHMOND PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44572 W BOWLIN RD
MARICOPA AZ
85138-4558
US

IV. Provider business mailing address

655 S DOBSON RD STE 101
CHANDLER AZ
85224-5668
US

V. Phone/Fax

Practice location:
  • Phone: 480-433-8514
  • Fax:
Mailing address:
  • Phone: 480-433-8514
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number11389
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: