Healthcare Provider Details

I. General information

NPI: 1700266251
Provider Name (Legal Business Name): KRISTI RICHARDS MSN, APRN, NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/30/2015
Last Update Date: 11/13/2024
Certification Date: 11/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

902 N ORANGE ST
MISSOULA MT
59802-2928
US

IV. Provider business mailing address

13280 EVENING CREEK DR S STE 225
SAN DIEGO CA
92128-4664
US

V. Phone/Fax

Practice location:
  • Phone: 406-329-5736
  • Fax: 406-329-2941
Mailing address:
  • Phone: 877-257-0637
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WW0000X
TaxonomyWound Care Registered Nurse
License Number689880
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP128800
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNUR-APRN-LIC-159356
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: