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Individual

DIANE K RICHARDSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
141 PORT SHELDON RD SW, GRANDVILLE, MI 49418-2149
(616) 235-2090
(616) 235-2099
Mailing address
PO BOX 1767, GRAND RAPIDS, MI 49501-1767
(616) 235-2090
(616) 235-2099

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
4704110245
MI

Other

Enumeration date
02/23/2006
Last updated
10/03/2011
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