Individual
CHRISTINA RENEE RICHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3646 MOUNT ELLIOTT ST, DETROIT, MI 48207-2311
(248) 234-1079
Mailing address
6309 MACK AVE, DETROIT, MI 48207-2302
(248) 234-1079
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704300157
MI
363LF0000X
Family Nurse Practitioner
Primary
4704300157
MI
Other
Enumeration date
05/09/2024
Last updated
12/20/2024
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