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NPI Code Detail

MEDICARE: MRS. COURTNEY RICHARDSON

MEDICARE:  MRS. COURTNEY  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
1363LF0000XFamily Nurse Practitioner0024192721VA
2363LF0000XFamily Nurse Practitioner5023440NC

General Provider Information

NPI Number : 1952700254
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. COURTNEY RICHARDSON
Provider Business Mailing Address
First Line : 245 MEMORIAL DR
Second Line :
City : JACKSONVILLE
State : NC
Zip : 28546-6333
Country : US
Telephone Number : 910-353-4333
Fax Number :
Provider Business Practice Location Address
First Line : 245 MEMORIAL DR
Second Line :
City : JACKSONVILLE
State : NC
Zip : 28546-6333
Country : US
Telephone Number : 910-353-4333
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/22/2014
Last Update Date : 05/12/2026

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Directions to “ MRS. COURTNEY RICHARDSON ” Practice Location

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