Provider Demographics
NPI:1730764879
Name:RICHARDS, ADRIENNE (RN)
Entity type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:
Last Name:RICHARDS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:ADRIENNE
Other - Middle Name:
Other - Last Name:BROYLES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:34412 SE SWENSON DR
Mailing Address - Street 2:
Mailing Address - City:SNOQUALMIE
Mailing Address - State:WA
Mailing Address - Zip Code:98065-5130
Mailing Address - Country:US
Mailing Address - Phone:425-831-3821
Mailing Address - Fax:
Practice Address - Street 1:34412 SE SWENSON DR
Practice Address - Street 2:
Practice Address - City:SNOQUALMIE
Practice Address - State:WA
Practice Address - Zip Code:98065-5130
Practice Address - Country:US
Practice Address - Phone:425-831-3821
Practice Address - Fax:425-831-3810
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-10
Last Update Date:2021-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00172651163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool