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General NPI Number Information
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NPI Number | 1376844357
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Entity Type | Individual
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Provider Name | SUE ANN RICHARDSON APRN, FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 11/08/2010
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Last Update Date | 02/19/2025
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Provider Practice Location Address
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Address Line | 1940 N JACKSON ST STE 220
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City | TULLAHOMA
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State | TN
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Zip | 37388-8256
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Country | US
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Telephone | 931-455-4616
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Fax | 931-455-2362
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Provider Business Mailing Address
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Address Line | 2196 WAYSIDE RD
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City | MANCHESTER
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State | TN
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Zip | 37355-6824
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Country | US
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Telephone | 931-841-1314
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APN0000015298
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APN15298
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License Number State | TN
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