Provider Demographics
NPI:1578107439
Name:RICHARDS, EMILY SUE (NP-C)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:SUE
Last Name:RICHARDS
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:989 W 875 S
Mailing Address - Street 2:
Mailing Address - City:LEHI
Mailing Address - State:UT
Mailing Address - Zip Code:84043-5958
Mailing Address - Country:US
Mailing Address - Phone:208-520-4241
Mailing Address - Fax:
Practice Address - Street 1:1273 W 12600 S STE 403
Practice Address - Street 2:
Practice Address - City:RIVERTON
Practice Address - State:UT
Practice Address - Zip Code:84065-7111
Practice Address - Country:US
Practice Address - Phone:801-930-0411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-04
Last Update Date:2019-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT9502334-4405363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily