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Individual
DR. KELLY GOLLIHER RICHARDSON
Active
Individual
DR. KELLY GOLLIHER RICHARDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DNP
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
2013010497
TX
207QG0300X
Geriatric Medicine (Family Medicine) Physician
2010007126
TX
363L00000X
Nurse Practitioner
Primary
636991
TX
364SP0813X
Geropsychiatric Psychiatric/Mental Health Clinical Nurse Specialist
2021032810
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1306167879
—
TX
Enumeration date
06/18/2010
Last updated
08/24/2021
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