Healthcare Provider Details

I. General information

NPI: 1780801076
Provider Name (Legal Business Name): MARCIA KAREN RICHARDSON-HALL BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/19/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3805 CHESNEE CT
RALEIGH NC
27604-3344
US

IV. Provider business mailing address

3805 CHESNEE CT
RALEIGH NC
27604-3344
US

V. Phone/Fax

Practice location:
  • Phone: 919-875-9141
  • Fax:
Mailing address:
  • Phone: 919-875-9141
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License Number161938
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: