Individual
MICHELLE RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
255 IA WAY, WAHIAWA, HI 96786-5211
(808) 479-6379
Mailing address
94-450 MOKUOLA ST STE 100, WAIPAHU, HI 96797-3388
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
19253
HI
Other
Enumeration date
05/10/2019
Last updated
05/10/2019
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