MEDICARE: YEONG RICHARDSON

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
1	163WA2000X	Administrator Registered Nurse	RN0185593	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1629582952
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YEONG RICHARDSON

Provider Business Mailing Address
First Line	:	5813 S DANUBE ST
Second Line	:
City	:	AURORA
State	:	CO
Zip	:	80015-5104
Country	:	US
Telephone Number	:	720-277-5116
Fax Number	:

Provider Business Practice Location Address
First Line	:	2060 S HAVANA ST
Second Line	:
City	:	AURORA
State	:	CO
Zip	:	80014-1014
Country	:	US
Telephone Number	:	303-750-0036
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/22/2017
Last Update Date	:	11/22/2017

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Directions to “ YEONG RICHARDSON ” Practice Location

Language	Start Address	Practice Location

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