Individual
MS. STEPHANIE RICHMOND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
703 SOUTH CHRISTOPHER ROAD, BELEN, NM 87002
(505) 864-7781
(505) 864-7781
Mailing address
933 BRADBURY DR SE, STE 1134, ALBUQUERQUE, NM 87106-4375
(505) 272-0148
(505) 272-9991
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA2005-0027
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
46076565
—
NM
Enumeration date
07/10/2006
Last updated
06/15/2023
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