Healthcare Provider Details

I. General information

NPI: 1568814127
Provider Name (Legal Business Name): NORA VIRGINIA RICHARDS L.M.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2016
Last Update Date: 10/07/2025
Certification Date: 10/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1257 W LAKE BLVD
WINONA MN
55987-5365
US

IV. Provider business mailing address

1257 W LAKE BLVD
WINONA MN
55987-5365
US

V. Phone/Fax

Practice location:
  • Phone: 773-538-7406
  • Fax:
Mailing address:
  • Phone: 773-538-7406
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number10015630
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number21670
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: