Individual
MRS. BRENDA C RICHARDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
508 SENECA ST, FULTON, NY 13069-1335
(315) 598-5120
Mailing address
508 SENECA ST, FULTON, NY 13069-1335
(315) 598-5120
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
269202
NY
Other
Enumeration date
04/19/2014
Last updated
04/19/2014
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