Provider Demographics
NPI:1689163883
Name:RICHARDS, KERI-ANN (FNP)
Entity Type:Individual
Prefix:
First Name:KERI-ANN
Middle Name:
Last Name:RICHARDS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:KERI-ANN
Other - Middle Name:
Other - Last Name:RICHARDS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP
Mailing Address - Street 1:88 CLARKSON ST FL 2
Mailing Address - Street 2:
Mailing Address - City:ANSONIA
Mailing Address - State:CT
Mailing Address - Zip Code:06401-1136
Mailing Address - Country:US
Mailing Address - Phone:860-316-9831
Mailing Address - Fax:
Practice Address - Street 1:88 CLARKSON ST
Practice Address - Street 2:
Practice Address - City:ANSONIA
Practice Address - State:CT
Practice Address - Zip Code:06401-1136
Practice Address - Country:US
Practice Address - Phone:860-316-9831
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-03
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY725371163W00000X
CT2023017822363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse