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Individual
DR. GWEN E RICHARDSON
Active
Individual
DR. GWEN E RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD CFNP
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28105011A
IN
363L00000X
Nurse Practitioner
Primary
71000365A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000278645
ANTHEM BLUE CROSS BLUE SH
—
01
—
92626
GEISINGER HEALTH PLAN
—
Enumeration date
09/29/2005
Last updated
07/13/2026
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