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General NPI Number Information
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NPI Number | 1578812624
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Entity Type | Individual
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Provider Name | JAMIE MARIE RICHARDSON CRNA
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Gender | Female
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Dates
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Enumeration Date | 09/05/2012
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Last Update Date | 08/12/2024
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Provider Practice Location Address
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Address Line | 1968 PEACHTREE RD NW
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City | ATLANTA
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State | GA
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Zip | 30309-1281
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Country | US
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Telephone | 678-216-0771
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Fax |
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Provider Business Mailing Address
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Address Line | 3601 W COMMERCIAL BLVD SUITE 5
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City | FT LAUDERDALE
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State | FL
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Zip | 33309-3300
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Country | US
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Telephone | 954-485-5666
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Fax | 954-484-1651
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 2071
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | ARNP9223195
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License Number State | FL
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