Individual
JUANITA M RICHARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.C.
Contact information
Practice address
4141 5TH ST, RAPID CITY, SD 57701-6021
(605) 341-2424
(605) 341-4547
Mailing address
4141 5TH ST, RAPID CITY, SD 57701-6021
(605) 341-2424
(605) 341-4547
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0385
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0005523
WELLMARK BCBS PIN
SD
05
—
6826050
—
SD
Enumeration date
03/22/2006
Last updated
11/13/2013
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