KELLY LYNAE RICHARDSON


Address: 5121 S Cottonwood St Ste 320, Murray, UT 84107-5701
Phone: 8015073380

KELLY LYNAE RICHARDSON (NPI# 1760618730) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1760618730
Entity Type Individual
Full Name KELLY LYNAE RICHARDSON
Credential PA-C
Practice Address 5121 S Cottonwood St Ste 320
Murray
UT 84107-5701
Mailing Address 2124 Buhl Ave
North Saint Paul
MN 55109
Practice Telephone 8015073380
Mailing Telephone 3038951675
Enumeration Date 2009-06-04
Last Update Date 2018-03-17
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363A00000X Physician Assistant 10561256-1206 UT Physician Assistants & Advanced Practice Nursing Providers
N 363A00000X Physician Assistant Physician Assistants & Advanced Practice Nursing Providers

Provider Secondary Practice Location

Address Telephone Number Fax Number
2045 Franklin St, Denver, CO 802055437 3032033797

Other Providers KELLY RICHARDSON

NPI Name Taxonomy Address Enumeration
1295162386 Kelly C Richardson Speech-Language Pathologist 3435 Main Street, 52 Biomedical Education Building, Ub Speech-language and Hearing Clinic, Buffalo, NY 14214-8016 2013-10-03
1306167879 Kelly Golliher Richardson Nurse Practitioner 314 Calumet Pl, San Antonio, TX 78209-3402 2010-06-18
1225038086 Kelly R Richardson Physician Assistant 914 N Dixie Ave, Suite 304, Elizabethtown, KY 42701-2520 2005-07-22
1255946851 Kelly Richardson Behavior Technician 4 Rossi Cir, Suite 141, Salinas, CA 93907-2362 2020-09-10
1811408214 Kelly Richardson Nurse Practitioner 2520 5th St N, Columbus, MS 39705-2008 2017-10-12
1952846032 Kelly Richardson Counselor 14255 Sw Brigadoon Ct, Beaverton, OR 97005-3369 2016-12-29
1730639857 Kelly Richardson Physical Therapist 2197 Madison St, Suite 106, Clarksville, TN 37043-5284 2016-10-13
1235527946 Kelly Richardson Marriage & Family Therapist 215 W Beamer St, Woodland, CA 95695-2510 2015-01-03
1558769661 Kelly Nicole Richardson Counselor 6707 Whitestone Rd, Gwynn Oak, MD 21207-4106 2014-12-05
1750707873 Kelly Richardson Counselor 602 Sw 38th St, Lawton, OK 73505-6912 2014-03-13

Office Location

Street Address 5121 S COTTONWOOD ST STE 320
City MURRAY
State UT
Zip Code 84107-5701

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1902410517 Brielle Nicole Poulter Student in an Organized Health Care Education/Training Program 345 East 4500 So #260, Murray, UT 84107 2020-09-01
1467016592 Ashlee Brown Social Worker C-134, 5284 Commerce Drive, Murray, Murray, UT 84107 2019-04-24
1568940633 Samantha Duff Occupational Therapist 5770 S Fashion Blvd, Bldg 5 Ste 201, Murray, UT 84107 2018-08-01
1881185247 Derek John Sharp Occupational Therapist 5770 S Fashion Blvd, Bldg #5, Suite 210, Murray, UT 84107 2018-05-22
1093223091 Erin Nicole Hill Counselor 345 East 4500 South Suite 260, Murray, UT 84107 2018-01-12
1588171219 Nicole Danielle Jensen Counselor 345 East 4500 South, Suite 260, Murray, UT 84107 2018-01-03
1043725799 Greater Endodontics LLC Dentist 5334 South Woodrow Street, Suite 201, Salt Lake City, UT 84107 2017-12-04
1043739667 Karyn K Hodge Audiologist 4500 So. 777. E. Ste #110, Murray, UT 84107 2017-09-14
1912426750 Brandon C Burton Specialist/Technologist, Other Cta Community Supports 4444 S, 700 E Suite 203, Salt Lake City, UT 84107 2017-09-13
1396261152 Megan Lehane Delano Plastic Surgery 5169 Cottonwood St Ste 420, Murray, UT 84107 2017-08-14
Find all providers in zip 84107

Taxonomy Information

Taxonomy Code 363A00000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant

Taxonomy Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1447725247 Shonti G. Breisch Physician Assistant 6150 S Vineway Cir, Murray, UT 84121-1947 2018-10-08
1043705866 Jeffery Mccleve Physician Assistant 5323 S Woodrow St Ste 100, Murray, UT 84107-5842 2018-06-25
1518402098 Philip John Swink Physician Assistant 650 E 4500 S Ste 100, Murray, UT 84107-4536 2016-12-20
1760849657 Molly Ann Nowill Physician Assistant 5169 S Cottonwood St Ste 501a, Murray, UT 84107-6767 2016-01-22
1114399839 Scott West Physician Assistant 5169 S Cottonwood St Ste 510, Murray, UT 84107-6770 2015-10-21
1679901169 Jennifer Aileen Wight Physician Assistant 5169 S Cottonwood St Ste 440, Murray, UT 84107-6774 2013-10-22
1164728960 Lex Kiyoshi Grimley Physician Assistant 5169 Cottonwood St Ste 520, Murray, UT 84107-6767 2011-01-27
1184887051 Meredith Evin Pike Physician Assistant 5450 S Green St, Murray, UT 84123-5632 2008-07-09
1215091525 Matthew M Neddo Physician Assistant 5911 S Fashion Blvd, Murray, UT 84107-7352 2006-12-21
1396830402 Pamela L Sunshine Physician Assistant 5131 S Cottonwood St # L-2, Murray, UT 84107-5701 2006-10-04
Find all providers in MURRAY

Competitor

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City MURRAY
Zip Code 84107

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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