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General NPI Number Information
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NPI Number | 1558717876
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Entity Type | Individual
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Provider Name | KELSEY ELAINE RICHARDSON MD
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Gender | Female
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Dates
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Enumeration Date | 05/05/2016
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Last Update Date | 07/25/2019
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Provider Practice Location Address
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Address Line | 1208 N I27
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City | PLAINVIEW
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State | TX
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Zip | 79072-3937
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Country | US
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Telephone | 806-291-5112
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Fax |
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Provider Business Mailing Address
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Address Line | 1208 N I27
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City | PLAINVIEW
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State | TX
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Zip | 79072-3937
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Country | US
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Telephone | 806-291-5112
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | BP10057216
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License Number State | TX
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