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General NPI Number Information
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NPI Number | 1992137517
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Entity Type | Individual
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Provider Name | ROBERT T RICHARDS CRNP
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Gender | Male
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Dates
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Enumeration Date | 08/06/2013
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Last Update Date | 04/09/2021
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Provider Practice Location Address
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Address Line | 1555 HIGHLANDS DR STE 100
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City | LITITZ
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State | PA
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Zip | 17543-2800
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Country | US
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Telephone | 717-299-5000
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Fax | 717-431-4310
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Provider Business Mailing Address
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Address Line | 1555 HIGHLANDS DR
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City | LITITZ
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State | PA
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Zip | 17543-2800
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN290896L
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | SP013113
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License Number State | PA
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