Basic Information
| Provider Information | |||||||||
| NPI: | 1255887667 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RICHMOND | ||||||||
| FirstName: | TORY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 308 W 8TH ST APT 702 | ||||||||
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| City: | KANSAS CITY | ||||||||
| State: | MO | ||||||||
| PostalCode: | 641051576 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8167876831 | ||||||||
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| Practice Location | |||||||||
| Address1: | 8424 E SHEA BLVD | ||||||||
| Address2: | 101 | ||||||||
| City: | SCOTTSDALE | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852606662 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4802561520 | ||||||||
| FaxNumber: | 4804786628 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/27/2016 | ||||||||
| LastUpdateDate: | 12/29/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 2009027351 | MO | N | Nursing Service Providers | Registered Nurse | 367500000X | 107773 | AZ | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
No ID Information.