=====================================================
General NPI Number Information
=====================================================
NPI Number | 1467854828
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KRISTIE L RICHMOND FNP-BC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/17/2014
-----------------------------------------------------
Last Update Date | 04/30/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 302 KNOLLCREST LN
-----------------------------------------------------
City | KNIGHTDALE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27545-6715
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 919-213-1403
-----------------------------------------------------
Fax | 919-277-0353
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 302 KNOLLCREST LN
-----------------------------------------------------
City | KNIGHTDALE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27545-6715
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 919-213-1403
-----------------------------------------------------
Fax | 919-277-0353
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 5009748
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363L00000X
-----------------------------------------------------
Taxonomy Name | Nurse Practitioner
-----------------------------------------------------
License Number | 5009748
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------