MEDICARE: CHELSEA RICHARDSON

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	163WE0003X	Emergency Registered Nurse	R126935	OK

General Provider Information

NPI Number	:	1255299145
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHELSEA RICHARDSON

Provider Business Mailing Address
First Line	:	1117 S CHOCTAW AVE
Second Line	:
City	:	SKIATOOK
State	:	OK
Zip	:	74070-1768
Country	:	US
Telephone Number	:	918-829-6762
Fax Number	:

Provider Business Practice Location Address
First Line	:	1011 HONOR HEIGHTS DR
Second Line	:
City	:	MUSKOGEE
State	:	OK
Zip	:	74401-1318
Country	:	US
Telephone Number	:	918-577-3726
Fax Number	:

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

Provider Enumeration Date	:	01/12/2026
Last Update Date	:	01/12/2026

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Directions to “ CHELSEA RICHARDSON ” Practice Location

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