Individual provider · NPI-1

Sandra J Richardson, NP

Nurse Practitioner, Obstetrics & Gynecology · Missoula, MT

NPI number1801560552
StatusActive
Last updated in NPPESMar 22, 2022

Details

NPI
1801560552
Entity type
Individual (NPI-1)
Name
Sandra J Richardson
Credential
NP
Sex
Female
Sole proprietor
No
Enumeration date
Aug 5, 2021
Certification date
Mar 22, 2022
Last updated
Mar 22, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LX0001X Nurse Practitioner, Obstetrics & Gynecology177829MTYes
163W00000X Registered Nurse21687MT

Practice location

500 W Broadway St
Missoula, MT 59802-4008

Phone 406-721-5600 · Fax 406-329-7103

Mailing address

Po Box 7609
Missoula, MT 59807-7609

Phone 406-721-5600

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