Individual
ALYSSA JUSTINE RICHARDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1421 PREMIER DR, MANKATO, MN 56001-6076
(507) 625-1811
Mailing address
1421 PREMIER DR, MANKATO, MN 56001-6076
(507) 625-1811
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
10647
MN
363LF0000X
Family Nurse Practitioner
10647
MN
363LP2300X
Primary Care Nurse Practitioner
Primary
10647
MN
Other
Enumeration date
09/14/2023
Last updated
09/14/2023
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