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General NPI Number Information
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NPI Number | 1336027192
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Entity Type | Individual
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Provider Name | ELIZABETH ELLIS RICHARDSON FNP
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Gender | Female
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Dates
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Enumeration Date | 08/21/2025
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Last Update Date | 08/21/2025
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Provider Practice Location Address
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Address Line | 506 MAIN ST
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City | SACO
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State | ME
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Zip | 04072-1530
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Country | US
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Telephone | 207-571-7991
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Fax | 207-571-7990
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Provider Business Mailing Address
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Address Line | 360 US HIGHWAY 1 BYP UNIT 102
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City | PORTSMOUTH
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State | NH
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Zip | 03801-7105
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Country | US
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Telephone | 603-410-6700
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Fax |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | CNP251520
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License Number State | ME
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