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NPI Code Detail

MEDICARE: REBECCA BLANTON RICHARDSON CRNA

MEDICARE: REBECCA BLANTON RICHARDSON CRNA
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
1367500000XCertified Registered Nurse Anesthetist201633NC

General Provider Information

NPI Number : 1801286943
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBECCA BLANTON RICHARDSON CRNA
Provider Business Mailing Address
First Line : 21A OAK BRANCH DR
Second Line :
City : GREENSBORO
State : NC
Zip : 27407-2145
Country : US
Telephone Number : 336-478-2664
Fax Number :
Provider Business Practice Location Address
First Line : 1211 VIRGINIA ST
Second Line :
City : GREENSBORO
State : NC
Zip : 27401-1313
Country : US
Telephone Number : 336-272-0012
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/28/2015
Last Update Date : 04/20/2026

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