Individual
KATHLEEN RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
311 S CLARK ST, CARROLL, IA 51401-3038
(712) 792-3581
(712) 792-2124
Mailing address
142 W RANDALL RD, CARROLL, IA 51401-3637
(712) 792-3141
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
77622
IA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
G 052035
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G 052035
IOWA LICENSE
IA
Enumeration date
09/20/2006
Last updated
03/23/2011
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