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Individual
TIFFANY LYNN RICHARDSON
Active
Individual
TIFFANY LYNN RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5799P
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000593282
ANTHEM BCBS
—
05
—
7100064850
—
KY
Enumeration date
11/06/2008
Last updated
11/08/2013
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