Individual
HEATHER NICCOLE RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
1717 S RANGE LINE RD, JOPLIN, MO 64804-3234
(417) 623-2207
Mailing address
1717 S RANGE LINE RD STE B, JOPLIN, MO 64804-3224
(417) 623-2207
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
205734
OK
363LF0000X
Family Nurse Practitioner
Primary
2022002215
MO
Other
Enumeration date
01/06/2022
Last updated
03/16/2022
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