Provider Demographics
NPI:1942503842
Name:RICHMOND, KAREN BETH (ASSOCIATE DEGREE)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:BETH
Last Name:RICHMOND
Suffix:
Gender:F
Credentials:ASSOCIATE DEGREE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:421 S LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:BLACKWELL
Mailing Address - State:OK
Mailing Address - Zip Code:74631
Mailing Address - Country:US
Mailing Address - Phone:580-789-0012
Mailing Address - Fax:580-763-6059
Practice Address - Street 1:201 E CHESTNUT AVE
Practice Address - Street 2:
Practice Address - City:PONCA CITY
Practice Address - State:OK
Practice Address - Zip Code:74601-4311
Practice Address - Country:US
Practice Address - Phone:580-763-6017
Practice Address - Fax:580-763-6059
Is Sole Proprietor?:No
Enumeration Date:2010-12-15
Last Update Date:2010-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator