Provider Demographics
NPI:1679974968
Name:RICHINS, ALISHA (FNP-BC)
Entity type:Individual
Prefix:
First Name:ALISHA
Middle Name:
Last Name:RICHINS
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:835 E 4800 S
Mailing Address - Street 2:SUITE 230
Mailing Address - City:MURRAY
Mailing Address - State:UT
Mailing Address - Zip Code:84107
Mailing Address - Country:US
Mailing Address - Phone:801-716-7008
Mailing Address - Fax:888-990-1557
Practice Address - Street 1:835 E 4800 S
Practice Address - Street 2:SUITE 230
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84107
Practice Address - Country:US
Practice Address - Phone:801-716-7008
Practice Address - Fax:888-990-1557
Is Sole Proprietor?:No
Enumeration Date:2014-09-06
Last Update Date:2016-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT52628874405363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily