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NPI Code Detail

MEDICARE: TESS C RICHERSON NP

MEDICARE: TESS C RICHERSON NP
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
1163W00000XRegistered Nurse249488-30WI
2363L00000XNurse Practitioner13312-033WI
3363LP0808XPsychiatric/Mental Health Nurse Practitioner13312-033WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1427775055
Entity Type Code : Individual
Provider Name (Legal Business Name) : TESS C RICHERSON NP
Provider Business Mailing Address
First Line : PO BOX 735044
Second Line :
City : CHICAGO
State : IL
Zip : 60673-5044
Country : US
Telephone Number : 800-326-2250
Fax Number :
Provider Business Practice Location Address
First Line : 1220 DEWEY AVE
Second Line :
City : WAUWATOSA
State : WI
Zip : 53213-2504
Country : US
Telephone Number : 414-773-4312
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/25/2022
Last Update Date : 12/08/2025

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