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Individual

DAVID WAYLON RICHARDSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
FNP-C

Contact information

Practice address
2032 S 17TH ST, SUITE 101, WILMINGTON, NC 28401-6678
(910) 763-3738
(910) 763-0454
Mailing address
2032 S 17TH ST, SUITE 101, WILMINGTON, NC 28401-6678
(910) 763-3738
(910) 763-0454

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
5004418
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7000566
NC
Enumeration date
07/14/2009
Last updated
07/17/2013
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