# DR. GWEN E RICHARDSON

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1598752156
- **Gender:** F
- **Credential:** PHD CFNP

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163W00000X | Registered Nurse | 28105011A | IN | — |
| 363L00000X | Nurse Practitioner | 71000365A | IN | Yes |

## Other

- **Enumeration date:** 09/29/2005
- **Last updated:** 07/13/2026

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000000278645 | ANTHEM BLUE CROSS BLUE SH | — |
| 01 | — | 92626 | GEISINGER HEALTH PLAN | — |