Individual
BETH ANN RICHARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, FNP-C
Contact information
Practice address
7333 W JEFFERSON BLVD, FORT WAYNE, IN 46804-6280
(260) 458-3830
(260) 458-3831
Mailing address
6920 POINTE INVERNESS WAY STE 200, FORT WAYNE, IN 46804-7934
(260) 479-3516
(260) 479-3520
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28114500A
IN
363LF0000X
Family Nurse Practitioner
Primary
71002635A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200905030
—
IN
Enumeration date
02/14/2008
Last updated
11/02/2021
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