Theresa A Richardson, RN

Individual provider Active NPI Registered Nurse · Chittenango, NY

NPI 1902152127 · NPPES record last updated Jul 25, 2012

Key facts

NPI
1902152127
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
655066-1 (NY)
Practice address
135 Laura CT
Chittenango, NY 13037-1508
Phone
(315) 687-7075
NPI assigned
Jul 25, 2012
Sex
Female
Sole proprietor
No

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
655066-1NYMDRegistered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 655066-1 NY Yes

Addresses

Primary practice location

135 Laura CT
Chittenango, NY 13037-1508

Mailing address

135 Laura CT
Chittenango, NY 13037-1508
Phone (315) 687-7075

Other providers in Chittenango, NY

All providers in Chittenango, NY · Registered Nurse in New York

Sources for this page

Verify at the official NPI Registry.