Individual
MARISA RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
327 MEDICAL PARK DR, BRIDGEPORT, WV 26330-9006
(681) 342-2200
Mailing address
327 MEDICAL PARK DR, BRIDGEPORT, WV 26330-9006
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
92367
WV
Other
Enumeration date
02/09/2016
Last updated
05/25/2017
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