Individual
KEESHA E RICHARDVILLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CST
Contact information
Practice address
225 CROSSLAKE DR, EVANSVILLE, IN 47715-8198
(812) 477-1558
Mailing address
225 CROSSLAKE DR, EVANSVILLE, IN 47715-8198
(812) 477-1558
Taxonomy
Speciality
Code
Description
License number
State
246ZS0410X
Surgical Technologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110001
CST CERTIFICATION
IN
Enumeration date
03/15/2021
Last updated
03/15/2021
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