Healthcare Provider Details

I. General information

NPI: 1932238458
Provider Name (Legal Business Name): DIANA HUFSTEDLER RICHARDSON RNC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/02/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31 MEDICAL DR
LINDEN TN
37096-3326
US

IV. Provider business mailing address

31 MEDICAL DR
LINDEN TN
37096-3326
US

V. Phone/Fax

Practice location:
  • Phone: 931-589-2138
  • Fax: 931-589-5414
Mailing address:
  • Phone: 931-589-2138
  • Fax: 931-589-5414

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WW0101X
TaxonomyAmbulatory Women's Health Care Registered Nurse
License NumberAPN0000011450
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: