Provider Demographics
NPI:1225783129
Name:RICHARDSON, KELLEY FINNEGAN (CNM)
Entity Type:Individual
Prefix:
First Name:KELLEY
Middle Name:FINNEGAN
Last Name:RICHARDSON
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2504 S ARLINGTON MILL DR APT C
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22206-4028
Mailing Address - Country:US
Mailing Address - Phone:571-217-3154
Mailing Address - Fax:
Practice Address - Street 1:106 IRVING ST NW STE 4400
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-2973
Practice Address - Country:US
Practice Address - Phone:202-877-2303
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-18
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No176B00000XOther Service ProvidersMidwife