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General NPI Number Information
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NPI Number | 1275787053
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Entity Type | Individual
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Provider Name | TIFFANY LYNN RICHARDSON ARNP
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Gender | Female
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Dates
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Enumeration Date | 11/06/2008
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Last Update Date | 11/08/2013
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Provider Practice Location Address
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Address Line | 1107 CROWN POINTE DR SUITE C
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City | ELIZABETHTOWN
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State | KY
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Zip | 42701-7123
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Country | US
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Telephone | 270-982-1200
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Fax | 270-234-1952
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Provider Business Mailing Address
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Address Line | PO BOX 2119
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City | ELIZABETHTOWN
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State | KY
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Zip | 42702-2119
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Country | US
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Telephone | 270-982-1200
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Fax | 270-234-1952
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 5799P
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License Number State | KY
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