Healthcare Provider Details

I. General information

NPI: 1043560329
Provider Name (Legal Business Name): KIMBERLY D RICHARDSON CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/14/2012
Last Update Date: 09/09/2025
Certification Date: 09/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3535 OLENTANGY RIVER RD
COLUMBUS OH
43214-3908
US

IV. Provider business mailing address

3525 OLENTANGY RIVER RD
COLUMBUS OH
43214-3937
US

V. Phone/Fax

Practice location:
  • Phone: 614-566-1997
  • Fax:
Mailing address:
  • Phone: 614-566-1997
  • Fax: 614-566-1946

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN.CNP.13764
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: