Provider Demographics
NPI:1861939381
Name:RICHMOND, DONNA (MBA, RN, CPDN, AE-C)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:RICHMOND
Suffix:
Gender:F
Credentials:MBA, RN, CPDN, AE-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9318 SHADYCREEK WAY
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21234-3434
Mailing Address - Country:US
Mailing Address - Phone:443-463-5524
Mailing Address - Fax:
Practice Address - Street 1:9318 SHADYCREEK WAY
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21234-3434
Practice Address - Country:US
Practice Address - Phone:443-463-5524
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-23
Last Update Date:2017-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR070055163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD7070G0OtherCAGE