Healthcare Provider Details

I. General information

NPI: 1598759268
Provider Name (Legal Business Name): JDEE KATHRYN RICHARDSON PH.D, ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 VISSING PARK RD
JEFFERSONVILLE IN
47130-5989
US

IV. Provider business mailing address

2700 VISSING PARK RD
JEFFERSONVILLE IN
47130-5989
US

V. Phone/Fax

Practice location:
  • Phone: 812-284-8000
  • Fax: 812-258-1094
Mailing address:
  • Phone: 812-284-8000
  • Fax: 812-258-1094

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number71001922
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: