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Individual
MRS. JULIANNE RICHARDS
Active
Individual
MRS. JULIANNE RICHARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA5839
MA
363AS0400X
Surgical Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MW1056818J
MASSACHUSETTS CONTROLLED SUBSTANCE REGISTRATION
MA
01
—
PA5839
PA STATE LICENSE
MA
Enumeration date
08/17/2016
Last updated
03/07/2023
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