Healthcare Provider Details

I. General information

NPI: 1093190928
Provider Name (Legal Business Name): ASHLEIGH RICHMOND
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2015
Last Update Date: 05/13/2021
Certification Date: 05/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10818 45TH AVE
PLEASANT PRAIRIE WI
53158-3947
US

IV. Provider business mailing address

10818 45TH AVE
PLEASANT PRAIRIE WI
53158-3947
US

V. Phone/Fax

Practice location:
  • Phone: 262-909-2371
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: