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General NPI Number Information
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NPI Number | 1588963912
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Entity Type | Individual
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Provider Name | JOHN PAUL RICHARDSON FNP
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Gender | Male
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Dates
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Enumeration Date | 03/24/2011
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Last Update Date | 04/13/2011
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Provider Practice Location Address
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Address Line | 251 LYERLY STREET SUITE 100
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City | CHATTANOOGA
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State | TN
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Zip | 37404-2136
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Country | US
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Telephone | 423-826-8000
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Fax | 423-826-8005
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Provider Business Mailing Address
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Address Line | 2300-B EAST THIRD STREET
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City | CHATTANOOGA
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State | TN
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Zip | 37404-2700
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Country | US
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Telephone | 423-702-7900
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Fax | 423-702-7905
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 154620
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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 | 15735
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License Number State | TN
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