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General NPI Number Information
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NPI Number | 1285051201
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Entity Type | Individual
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Provider Name | MARY A. RICHARDS RN, BS, CCM
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Gender | Female
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Dates
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Enumeration Date | 03/27/2014
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Last Update Date | 03/27/2014
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Provider Practice Location Address
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Address Line | 220 GREENE PLZ
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City | WAYNESBURG
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State | PA
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Zip | 15370-8144
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Country | US
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Telephone | 724-627-1951
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Fax | 724-627-1670
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Provider Business Mailing Address
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Address Line | 24 NANNIE ST
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City | WASHINGTON
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State | PA
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Zip | 15301-9735
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Country | US
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Telephone | 724-627-1951
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Fax | 724-627-1670
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number | RN184303L
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License Number State | PA
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