Healthcare Provider Details

I. General information

NPI: 1821805961
Provider Name (Legal Business Name): ASHLEY F RICHARDSON RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/12/2024
Last Update Date: 12/12/2024
Certification Date: 12/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2101 ELM ST N
FARGO ND
58102-2417
US

IV. Provider business mailing address

2101 ELM ST N
FARGO ND
58102-2417
US

V. Phone/Fax

Practice location:
  • Phone: 701-239-3700
  • Fax: 701-451-7894
Mailing address:
  • Phone: 701-239-3700
  • Fax: 701-451-7894

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License NumberR47911
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: