=====================================================
General NPI Number Information
=====================================================
NPI Number | 1619229366
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | RICHARD WILFRED ARTHUR APRN
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/04/2012
-----------------------------------------------------
Last Update Date | 06/30/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | USAMEDDAC 2480 LLEWELLYN AVE FORT GEORGE G MEADE
-----------------------------------------------------
City | FORT MEADE
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20755
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 301-677-8145
-----------------------------------------------------
Fax | 301-400-0858
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | USAMEDDAC 2480 LLEWELLYN AVE FORT GEORGE G MEADE
-----------------------------------------------------
City | FORT MEADE
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20755
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 301-677-8145
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
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 | 005163
-----------------------------------------------------
License Number State | CT
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | R232067
-----------------------------------------------------
License Number State | MD
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | F337563
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------