Individual
MRS. DIANE RICHARDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN, PMHNP-BC
Contact information
Practice address
169 W 2710 SOUTH CIR STE 202A, ST GEORGE, UT 84790-7205
(435) 990-5443
(480) 520-7515
Mailing address
169 W 2710 SOUTH CIR STE 202A, ST GEORGE, UT 84790-7205
(435) 990-5443
(480) 520-7515
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
6599632-4405
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6599632-4405
APRN LICENSE
UT
01
—
6599632-8900
APRN CONTROLLED SUBSTANCE
UT
Enumeration date
01/09/2021
Last updated
11/06/2023
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