Individual
LEAH KATHRYN RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
213 MIDDLEBURY ST, GOSHEN, IN 46528
(574) 534-3300
Mailing address
213 MIDDLEBURY ST, GOSHEN, IN 46528-2956
(574) 534-3300
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28204011A
IN
363L00000X
Nurse Practitioner
Primary
71008163A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300017737
—
IN
Enumeration date
06/25/2018
Last updated
12/31/2020
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