Individual
LINDA FAYE RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN-CNP
Contact information
Practice address
610 E 24TH ST, TISHOMINGO, OK 73460-3245
(580) 371-2343
(580) 371-3614
Mailing address
610 E 24TH ST, TISHOMINGO, OK 73460-3245
(580) 371-2343
(580) 371-3614
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
204266
OK
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
204266
OK
Other
Enumeration date
06/15/2021
Last updated
12/19/2022
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