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NPI Code Detail

MEDICARE: BEVERLY KAY RICHARDSON FNP

MEDICARE: BEVERLY KAY RICHARDSON FNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner19461CA

General Provider Information

NPI Number : 1538495312
Entity Type Code : Individual
Provider Name (Legal Business Name) : BEVERLY KAY RICHARDSON FNP
Provider Business Mailing Address
First Line : 4984 ROSELLE CMN
Second Line :
City : FREMONT
State : CA
Zip : 94536-7921
Country : US
Telephone Number : 510-713-8932
Fax Number :
Provider Business Practice Location Address
First Line : 401 WARREN ST
Second Line :
City : REDWOOD CITY
State : CA
Zip : 94063-1578
Country : US
Telephone Number : 650-740-9538
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/28/2009
Last Update Date : 10/28/2009

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Directions to “ BEVERLY KAY RICHARDSON FNP” Practice Location

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