Individual
DR. AMANDA JEAN RICHARDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
X
Credential
RN, PMHNP-BC
Contact information
Practice address
9655 SCHMIDT LAKE RD, PLYMOUTH, MN 55442-4529
(763) 559-1640
Mailing address
13305 UPTON AVE S, BURNSVILLE, MN 55337-2171
(763) 913-8969
Taxonomy
Speciality
Code
Description
License number
State
163WP0807X
Child & Adolescent Psychiatric/Mental Health Registered Nurse
179569-9
MN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
11728
MN
Other
Enumeration date
06/27/2022
Last updated
06/28/2024
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