Provider Demographics
NPI:1639596109
Name:RICHARDSON, MARIA BARBOSA (CPNP, FNP-BC)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:BARBOSA
Last Name:RICHARDSON
Suffix:
Gender:F
Credentials:CPNP, FNP-BC
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:BARBOSA
Other - Last Name:DEANDRADE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:702 REXFORD WAY
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-8440
Mailing Address - Country:US
Mailing Address - Phone:617-956-2584
Mailing Address - Fax:
Practice Address - Street 1:13975 CONNECTICUT AVE
Practice Address - Street 2:
Practice Address - City:ASPEN HILL
Practice Address - State:MD
Practice Address - Zip Code:20906-2921
Practice Address - Country:US
Practice Address - Phone:301-557-1936
Practice Address - Fax:301-557-1949
Is Sole Proprietor?:No
Enumeration Date:2014-03-23
Last Update Date:2020-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR210081363LP2300X, 363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics