Individual
JOSHUA RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
3333 W DEYOUNG ST, MARION, IL 62959-5884
(618) 998-7000
Mailing address
127 GRIBBLE DR, CARRIER MILLS, IL 62917-1246
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041.395411
IL
363LF0000X
Family Nurse Practitioner
Primary
209.017738
IL
Other
Enumeration date
07/15/2018
Last updated
07/15/2018
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