Healthcare Provider Details

I. General information

NPI: 1801306519
Provider Name (Legal Business Name): KATHERINE LEIGH RICHARDS FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATHERINE ANN TERRELL FNP

II. Dates (important events)

Enumeration Date: 10/08/2017
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1710 N GLOSTER ST
TUPELO MS
38804-1216
US

IV. Provider business mailing address

499 EMILY FAITH CIR
HAMILTON AL
35570-5451
US

V. Phone/Fax

Practice location:
  • Phone: 662-840-6824
  • Fax:
Mailing address:
  • Phone: 205-468-1902
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number902358
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: