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General NPI Number Information
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NPI Number | 1467795690
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Entity Type | Individual
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Provider Name | AUTUMN ZEA RICHARDSON APRN
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Gender | Female
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Dates
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Enumeration Date | 04/06/2013
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Last Update Date | 04/06/2013
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Provider Practice Location Address
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Address Line | 350 HOSPITAL WAY
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City | SOMERSET
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State | KY
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Zip | 42503-2872
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Country | US
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Telephone | 606-451-2600
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Fax |
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Provider Business Mailing Address
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Address Line | 941 ELIHU RUSH BRANCH RD
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City | SOMERSET
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State | KY
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Zip | 42501-5811
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Country | US
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Telephone | 606-416-8487
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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 | 3007999
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License Number State | KY
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