Individual
TYLER RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
216 ANAMARIA DR, RAPID CITY, SD 57701-7366
(605) 721-4700
Mailing address
3411 IVY AVE, RAPID CITY, SD 57701-7543
(605) 415-5480
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
CR001174
SD
Other
Enumeration date
06/19/2024
Last updated
06/19/2024
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