# SHACONYA L RICHARDSON

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1548916810
- **Authorized official:** STEVEN C MITCHELL (CREDENTIALING AGENT)
- **Authorized official phone:** (502) 654-3927

## Contact information

- **Practice address:** 714 LYNDON LN STE 6, LOUISVILLE, KY 40222-4643
- **Practice address phone:** (502) 225-4900
- **Mailing address:** 6007 COUNT TURF DR, LOUISVILLE, KY 40272-3549
- **Mailing address phone:** (502) 243-5565

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 02/25/2022
- **Last updated:** 02/25/2022