Provider Demographics
NPI:1548480064
Name:RICHARDSON, RITA BYRNE (CNM)
Entity type:Individual
Prefix:
First Name:RITA
Middle Name:BYRNE
Last Name:RICHARDSON
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91-1575 WAHANE ST
Mailing Address - Street 2:
Mailing Address - City:KAPOLEI
Mailing Address - State:HI
Mailing Address - Zip Code:96707-3106
Mailing Address - Country:US
Mailing Address - Phone:808-674-1926
Mailing Address - Fax:808-477-0005
Practice Address - Street 1:91-1575 WAHANE ST
Practice Address - Street 2:
Practice Address - City:KAPOLEI
Practice Address - State:HI
Practice Address - Zip Code:96707-3106
Practice Address - Country:US
Practice Address - Phone:808-674-1926
Practice Address - Fax:808-477-0005
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIRN27485163W00000X
HIAPN 982363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163W00000XNursing Service ProvidersRegistered Nurse
Not Answered363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health