MEDICARE: MISS FINEICE RENEE RICHARDSON

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
1	251B00000X	Case Management Agency
2	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1629586805
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS FINEICE RENEE RICHARDSON

Provider Business Mailing Address
First Line	:	135 MERCHANT ST
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45246-3735
Country	:	US
Telephone Number	:	513-252-0248
Fax Number	:

Provider Business Practice Location Address
First Line	:	135 MERCHANT ST
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45246-3735
Country	:	US
Telephone Number	:	513-252-0248
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/22/2018
Last Update Date	:	08/08/2024

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