Healthcare Provider Details

I. General information

NPI: 1285600049
Provider Name (Legal Business Name): KAREN J. RICHARDSON APN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/23/2006
Last Update Date: 06/18/2021
Certification Date: 06/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1012 E CHURCH ST SUITE A
WARREN AR
71671-3509
US

IV. Provider business mailing address

1012 E CHURCH ST SUITE A
WARREN AR
71671-3509
US

V. Phone/Fax

Practice location:
  • Phone: 870-226-6754
  • Fax: 870-226-7925
Mailing address:
  • Phone: 870-226-6754
  • Fax: 870-226-7925

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberA01166
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: