Healthcare Provider Details

I. General information

NPI: 1629018924
Provider Name (Legal Business Name): JUNE A RICHMOND APN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2006
Last Update Date: 02/22/2021
Certification Date: 02/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

613 EXECUTIVE DR
PRINCETON NJ
08540-1528
US

IV. Provider business mailing address

PO BOX 85
SKILLMAN NJ
08558-0085
US

V. Phone/Fax

Practice location:
  • Phone: 609-945-2565
  • Fax:
Mailing address:
  • Phone: 609-945-5724
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberN010617600
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number26NJ00064700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: