Penny Jill Richards, RN

Individual provider Active NPI School Registered Nurse · Maxwell, NM

NPI 1558967984 · NPPES record last updated Oct 18, 2023

Key facts

NPI
1558967984
Entity type
Individual (NPI type 1)
Primary specialty
School Registered Nurse 163WS0200X
License
2009018552 (MO)
Practice address
4TH and Parque
Maxwell, NM 87728
Phone
(575) 375-3003
NPI assigned
Dec 10, 2020
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
2009018552MOMDSchool Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Maxwell Municipal Schools Past
since Dec 13, 2020
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
School Registered Nurse 163WS0200X 2009018552 MO Yes

Addresses

Primary practice location

4TH and Parque
Maxwell, NM 87728

Mailing address

PO Box 275
Maxwell, NM 87728-0275
Phone (575) 375-3003

Other providers in Maxwell, NM

All providers in Maxwell, NM · School Registered Nurse in New Mexico

Sources for this page

Verify at the official NPI Registry.