Individual
CLARISSA LYNNE RICHES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
9450 S 1300 E, SANDY, UT 84094-5555
(801) 501-2140
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
8642674-4405
UT
363LF0000X
Family Nurse Practitioner
AP60981821
WA
Other
Enumeration date
07/16/2019
Last updated
07/29/2022
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