Provider Demographics
NPI:1659361046
Name:RICHMOND, CHERRILYN FLEMMING (APRN)
Entity Type:Individual
Prefix:
First Name:CHERRILYN
Middle Name:FLEMMING
Last Name:RICHMOND
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 HOWARD AVE
Mailing Address - Street 2:YALE PHYSICIAN'S BUILDING, 3RD FLOOR
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06519-1369
Mailing Address - Country:US
Mailing Address - Phone:203-785-4176
Mailing Address - Fax:203-785-5886
Practice Address - Street 1:800 HOWARD AVE
Practice Address - Street 2:YALE PHYSICIAN'S BUILDING, 3RD FLOOR
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06519-1369
Practice Address - Country:US
Practice Address - Phone:203-785-4176
Practice Address - Fax:203-785-5886
Is Sole Proprietor?:No
Enumeration Date:2005-10-26
Last Update Date:2016-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002998363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004241379Medicaid
Q06835Medicare UPIN