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General NPI Number Information
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NPI Number | 1578953303
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Entity Type | Individual
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Provider Name | AMANDA ELISE RICHARDSON PA
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Gender | Female
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Dates
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Enumeration Date | 02/02/2015
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Last Update Date | 10/13/2025
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Provider Practice Location Address
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Address Line | 140 CHRISTIANSBURG PIKE NE
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City | FLOYD
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State | VA
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Zip | 24091-3742
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Country | US
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Telephone | 540-745-9290
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Fax | 540-745-9293
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Provider Business Mailing Address
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Address Line | 16 WALNUT AVE SW
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City | ROANOKE
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State | VA
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Zip | 24016-4719
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Country | US
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Telephone | 540-345-6468
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Fax | 540-345-3204
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 1124168
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License Number State | VA
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