1336930429 NPI number — MS. KAMRYN SCOTT RICHARDS NONE

Table of content: MS. KAMRYN SCOTT RICHARDS NONE (NPI 1336930429)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1336930429 NPI number — MS. KAMRYN SCOTT RICHARDS NONE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RICHARDS
Provider First Name:
KAMRYN
Provider Middle Name:
SCOTT
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
NONE
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
RICHARDS
Provider Other First Name:
KAMRYN
Provider Other Middle Name:
SCOTT
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
NONE
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1336930429
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/16/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
833 BARRINGTON RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GROSSE POINTE PARK
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48230-1726
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
313-204-7656
Provider Business Mailing Address Fax Number:
313-204-7656

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
833 BARRINGTON RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GROSSE POINTE PARK
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48230-1726
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
313-204-7656
Provider Business Practice Location Address Fax Number:
313-204-7656
Provider Enumeration Date:
05/16/2025

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 106S00000X , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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