Healthcare Provider Details

I. General information

NPI: 1225290190
Provider Name (Legal Business Name): NATALIE R. RICHARDS PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NATALIE KARST

II. Dates (important events)

Enumeration Date: 07/01/2008
Last Update Date: 06/22/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11700 N MERIDIAN ST
CARMEL IN
46032-4656
US

IV. Provider business mailing address

250 N SHADELAND AVENUE SUITE 130
INDIANAPOLIS IN
46219-4959
US

V. Phone/Fax

Practice location:
  • Phone: 317-688-3139
  • Fax: 317-688-2664
Mailing address:
  • Phone: 317-963-0860
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number10000998A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number10000998A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: