Provider Demographics
NPI:1871013037
Name:RICHARDS, LORRAINE MARIE (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:LORRAINE
Middle Name:MARIE
Last Name:RICHARDS
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
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Mailing Address - Street 1:8170 33RD AVE S # MS 21110Q
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55425-4516
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3931 LOUISIANA AVE S
Practice Address - Street 2:
Practice Address - City:ST LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55426-5000
Practice Address - Country:US
Practice Address - Phone:952-993-3230
Practice Address - Fax:952-993-1748
Is Sole Proprietor?:No
Enumeration Date:2017-06-20
Last Update Date:2021-03-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MN5189363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily