Provider Demographics
NPI:1144746637
Name:FINEDELL, RICHARD ALVIN JR (NP)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:ALVIN
Last Name:FINEDELL
Suffix:JR
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:601 JOHN ST # 42
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49007-5341
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10310 MILLER DR
Practice Address - Street 2:
Practice Address - City:GALESBURG
Practice Address - State:MI
Practice Address - Zip Code:49053
Practice Address - Country:US
Practice Address - Phone:269-286-7150
Practice Address - Fax:269-286-7151
Is Sole Proprietor?:No
Enumeration Date:2017-08-17
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704236467363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily