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General NPI Number Information
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NPI Number | 1306110366
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Entity Type | Individual
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Provider Name | JANICE RENEA RICHARDSON AGNP
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Gender | Female
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Dates
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Enumeration Date | 03/07/2012
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Last Update Date | 09/23/2025
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Provider Practice Location Address
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Address Line | 1350 E LANCASTER AVE STE 100
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City | FORT WORTH
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State | TX
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Zip | 76102-6671
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Country | US
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Telephone | 817-702-8391
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Fax | 817-702-4102
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Provider Business Mailing Address
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Address Line | PO BOX 40411
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City | BELFAST
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State | ME
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Zip | 04915-1255
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Country | US
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Telephone | 972-870-5511
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Fax |
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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 | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 601924
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 601924
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | AP117208
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License Number State | TN
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Taxonomy #4
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | AP117208
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License Number State | TX
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