Individual
KRYSTAL RICHARDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
14833 WELLER LN, ROSEDALE, NY 11422-2811
(917) 349-1358
Mailing address
14833 WELLER LN, ROSEDALE, NY 11422-2811
(917) 349-1358
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F309212-01
NY
Other
Enumeration date
08/25/2019
Last updated
08/25/2019
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