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NPI Code Detail

MEDICARE: THERESA JEANETTE RICHARDSON PA-C

MEDICARE: THERESA JEANETTE RICHARDSON PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant5601006158MI

General Provider Information

NPI Number : 1285916825
Entity Type Code : Individual
Provider Name (Legal Business Name) : THERESA JEANETTE RICHARDSON PA-C
Provider Business Mailing Address
First Line : 1101 W UNIVERSITY DR
Second Line :
City : ROCHESTER
State : MI
Zip : 48307-1863
Country : US
Telephone Number : 248-652-5000
Fax Number : 248-650-9160
Provider Business Practice Location Address
First Line : 1101 W UNIVERSITY DR
Second Line :
City : ROCHESTER
State : MI
Zip : 48307-1863
Country : US
Telephone Number : 248-652-5000
Fax Number : 248-650-9160
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/09/2011
Last Update Date : 06/01/2026

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Directions to “ THERESA JEANETTE RICHARDSON PA-C” Practice Location

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