Individual
DAKOTA RICHERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1520 S LIBERTY DR, BLOOMINGTON, IN 47403-5167
(812) 676-4500
Mailing address
1456 ROGERS RD, WEST FRANKFORT, IL 62896-5452
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
10004895A
IN
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
05/15/2025
Last updated
11/26/2025
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