Provider Demographics
NPI:1467854828
Name:RICHMOND, KRISTIE L (FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:KRISTIE
Middle Name:L
Last Name:RICHMOND
Suffix:
Gender:
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 KNOLLCREST LN
Mailing Address - Street 2:
Mailing Address - City:KNIGHTDALE
Mailing Address - State:NC
Mailing Address - Zip Code:27545-6715
Mailing Address - Country:US
Mailing Address - Phone:919-213-1403
Mailing Address - Fax:919-277-0353
Practice Address - Street 1:302 KNOLLCREST LN
Practice Address - Street 2:
Practice Address - City:KNIGHTDALE
Practice Address - State:NC
Practice Address - Zip Code:27545-6715
Practice Address - Country:US
Practice Address - Phone:919-213-1403
Practice Address - Fax:919-277-0353
Is Sole Proprietor?:No
Enumeration Date:2014-09-17
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5009748363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner