Richards, Juanita M

Richards, Juanita M is an individual health care provider with primary practice located at 4141 5Th St , Rapid City SD 57701-6021. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Richards, Juanita M can be contacted via phone (605) 341-2424.

Contact Information

Primary practice address
4141 5Th St Rapid City SD 57701-6021
Phone: (605) 341-2424
Fax: (605) 341-4547
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 0385 South Dakota

Profile Details

NPI number 1932168325
LBN Legal business name Richards, Juanita M
Credentials P.A.C.
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 22nd, 2006
Last updated Nov 13th, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1932168325 NPPES
South Dakota Other 0005523 WELLMARK BCBS PIN
South Dakota MEDICAID 6826050 WELLMARK BCBS PIN

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