Healthcare Provider Details

I. General information

NPI: 1598913055
Provider Name (Legal Business Name): CHARLES HEWITT RICHIE R.N.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/08/2008
Last Update Date: 09/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 CAMPUS DR
HANFORD CA
93230-4375
US

IV. Provider business mailing address

330 CAMPUS DR
HANFORD CA
93230-4375
US

V. Phone/Fax

Practice location:
  • Phone: 559-582-3211
  • Fax: 559-589-0482
Mailing address:
  • Phone: 559-832-3211
  • Fax: 559-589-0482

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License NumberRN676536
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: