=====================================================
General NPI Number Information
=====================================================
NPI Number | 1295053510
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | TNESHIA LEA RICHARDS RN, FNP-C
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/11/2010
-----------------------------------------------------
Last Update Date | 02/06/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 47 EAST FORK ROAD
-----------------------------------------------------
City | SYLVA
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28779-8002
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 286-312-7178
-----------------------------------------------------
Fax | 828-631-9697
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 47 EAST FORK ROAD
-----------------------------------------------------
City | SYLVA
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28779-8002
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 828-631-2717
-----------------------------------------------------
Fax | 828-631-9697
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 163W00000X
-----------------------------------------------------
Taxonomy Name | Registered Nurse
-----------------------------------------------------
License Number | 210468
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 5013326
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------