Healthcare Provider Details

I. General information

NPI: 1164952834
Provider Name (Legal Business Name): SHERRI ANN RICHARDSON CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2017
Last Update Date: 06/15/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15225 HIGHWAY 43 STE B
RUSSELLVILLE AL
35653-1969
US

IV. Provider business mailing address

930 FRANKLIN ST SE
HUNTSVILLE AL
35801-4312
US

V. Phone/Fax

Practice location:
  • Phone: 256-331-5828
  • Fax: 256-801-6727
Mailing address:
  • Phone: 256-801-6504
  • Fax: 256-801-6727

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number1-067097
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: