Provider Demographics
NPI:1881891083
Name:RICHARDS, MICHAEL J (CRNP)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:J
Last Name:RICHARDS
Suffix:
Gender:M
Credentials:CRNP
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:154 EXTON SQUARE MALL
Mailing Address - Street 2:
Mailing Address - City:EXTON
Mailing Address - State:PA
Mailing Address - Zip Code:19341-2440
Mailing Address - Country:US
Mailing Address - Phone:484-565-1293
Mailing Address - Fax:
Practice Address - Street 1:154 EXTON SQUARE MALL
Practice Address - Street 2:
Practice Address - City:EXTON
Practice Address - State:PA
Practice Address - Zip Code:19341-2440
Practice Address - Country:US
Practice Address - Phone:484-565-1293
Practice Address - Fax:484-903-1084
Is Sole Proprietor?:No
Enumeration Date:2007-06-29
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PASP009380363LF0000X
DELG0000442207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine