Individual
MRS. AMANDA LEE RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
1919 E THOMAS RD, PHOENIX, AZ 85016-7710
(602) 933-2311
(602) 933-4269
Mailing address
3200 E CAMELBACK RD STE 250, PHOENIX, AZ 85018-2327
(602) 933-1814
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP4235
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
671561
—
AZ
Enumeration date
11/18/2011
Last updated
02/06/2018
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