MEDICARE: LORRIE RICHARDSON APN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	21593	TN

General Provider Information

NPI Number	:	1245784818
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LORRIE RICHARDSON APN

Provider Business Mailing Address
First Line	:	4805 COLUMBIA PIKE
Second Line	:
City	:	THOMPSONS STATION
State	:	TN
Zip	:	37179-5207
Country	:	US
Telephone Number	:	615-791-0974
Fax Number	:

Provider Business Practice Location Address
First Line	:	4805 COLUMBIA PIKE
Second Line	:
City	:	THOMPSONS STATION
State	:	TN
Zip	:	37179-5207
Country	:	US
Telephone Number	:	615-791-0974
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/11/2016
Last Update Date	:	08/04/2021

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