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NPI Code Detail

MEDICARE: CHRISTINA RICHARDSON

MEDICARE: CHRISTINA 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
1363AS0400XSurgical Physician AssistantMED-PAC-LIC-60845MT
2363AS0400XSurgical Physician Assistant01774WV

General Provider Information

NPI Number : 1902237167
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTINA RICHARDSON
Provider Business Mailing Address
First Line : 132 FALCONERS WAY
Second Line :
City : BOZEMAN
State : MT
Zip : 59718-9022
Country : US
Telephone Number : 406-595-7181
Fax Number :
Provider Business Practice Location Address
First Line : 3400 LARAMIE DR
Second Line :
City : BOZEMAN
State : MT
Zip : 59718-2005
Country : US
Telephone Number : 406-587-0122
Fax Number : 844-656-2480
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/12/2013
Last Update Date : 12/08/2025

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Directions to “ CHRISTINA RICHARDSON ” Practice Location

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