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General NPI Number Information
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NPI Number | 1124816624
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Entity Type | Organization
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Legal Business Name | RICHMOND HEALTH & WELLNESS
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Dates
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Enumeration Date | 04/25/2025
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Last Update Date | 06/10/2025
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Provider Practice Location Address
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Address Line | 501 BAXTER AVE STE 125
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City | LOUISVILLE
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State | KY
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Zip | 40204-1103
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Country | US
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Telephone | 812-267-6367
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Fax |
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Provider Business Mailing Address
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Address Line | 1939 TREVILIAN WAY
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City | LOUISVILLE
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State | KY
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Zip | 40205-2139
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Country | US
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Telephone | 812-267-6367
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KIMBERLY JANE RICHMOND
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Credential | DNP APRN
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Telephone | 812-267-6367
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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