Healthcare Provider Details

I. General information

NPI: 1942745575
Provider Name (Legal Business Name): CATHERINE ASHLEY RICHARDS CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/06/2017
Last Update Date: 01/06/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4700 WATERS AVE
SAVANNAH GA
31404-6220
US

IV. Provider business mailing address

PO BOX 13428
SAVANNAH GA
31416-0428
US

V. Phone/Fax

Practice location:
  • Phone: 912-350-3849
  • Fax:
Mailing address:
  • Phone: 912-350-3849
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1-136305
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF1216719
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: