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General NPI Number Information
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NPI Number | 1174302947
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Entity Type | Organization
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Legal Business Name | RIVERSIDE HEALTH, LLC
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Dates
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Enumeration Date | 09/21/2023
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Last Update Date | 05/13/2025
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Provider Practice Location Address
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Address Line | 4112 RIVERSIDE DR
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City | HUNTINGTON
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State | WV
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Zip | 25705-1746
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Country | US
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Telephone | 681-204-5535
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Fax | 681-204-5435
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Provider Business Mailing Address
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Address Line | PO BOX 136
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City | BARBOURSVILLE
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State | WV
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Zip | 25504-0136
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Country | US
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Telephone | 681-204-5535
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Fax | 681-204-5435
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Authorized Official
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Title or Position | OWNER
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Name | ABIGAIL LYNN RICHARDSON
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Credential | FNP
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Telephone | 681-204-5535
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family 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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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