Individual
MACKENZIE RICHARDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
473 EASTERN AVE, MALDEN, MA 02148-4201
(518) 651-5745
Mailing address
25 CHARLTON ST APT 709, EVERETT, MA 02149-2478
(518) 651-5745
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN2311122
MA
363LF0000X
Family Nurse Practitioner
Primary
RN2311122
MA
Other
Enumeration date
07/28/2020
Last updated
09/03/2020
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