Provider Demographics
NPI:1013434695
Name:GEBHARDT, RICHARD FRANCIS (CRNP, FNP-C)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:FRANCIS
Last Name:GEBHARDT
Suffix:
Gender:M
Credentials:CRNP, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12870 KING ST
Mailing Address - Street 2:
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80020-3853
Mailing Address - Country:US
Mailing Address - Phone:205-329-0360
Mailing Address - Fax:
Practice Address - Street 1:3400 MAIN ST
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98663-2223
Practice Address - Country:US
Practice Address - Phone:360-696-5232
Practice Address - Fax:360-696-5228
Is Sole Proprietor?:No
Enumeration Date:2017-08-24
Last Update Date:2022-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY345142363L00000X
AL1-089091363LF0000X
WAAP60983706363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner