Healthcare Provider Details

I. General information

NPI: 1184304255
Provider Name (Legal Business Name): MCKAYLA L RICHARDSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2023
Last Update Date: 07/24/2023
Certification Date: 07/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 E MARKET ST
AKRON OH
44308-2015
US

IV. Provider business mailing address

1040 CLYDE AVE
CUYAHOGA FALLS OH
44221-5189
US

V. Phone/Fax

Practice location:
  • Phone: 330-761-7500
  • Fax:
Mailing address:
  • Phone: 330-949-8908
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: