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General NPI Number Information
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NPI Number | 1659027803
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Entity Type | Individual
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Provider Name | CHRISTINA MARIE RICHARDS NP- C
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Gender | Female
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Dates
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Enumeration Date | 02/25/2022
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Last Update Date | 11/29/2023
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Provider Practice Location Address
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Address Line | 2088 NE KIM LN
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City | BEND
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State | OR
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Zip | 97701-6588
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Country | US
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Telephone | 541-504-6010
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Fax |
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Provider Business Mailing Address
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Address Line | 3265 HILLCREST PARK DR
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City | MEDFORD
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State | OR
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Zip | 97504-7657
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Country | US
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Telephone |
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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 | 95020136
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 202208609NP-PP
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License Number State | OR
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