Individual
MS. JIAJOYCE RENEE RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
4518 UNION DEPOSIT RD, HARRISBURG, PA 17111-2921
(717) 526-1030
(717) 741-9605
Mailing address
4518 UNION DEPOSIT RD, HARRISBURG, PA 17111-2921
(717) 526-1030
(717) 741-9605
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
R149858
MD
363LF0000X
Family Nurse Practitioner
Primary
SP009284
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102130992-0001
—
PA
01
—
125050E7M
MEDICARE IND
PA
05
—
4123778-00
—
MD
01
—
50078124
BLUE CROSS INDIVIDUAL
PA
01
—
893477-01
BLUE CROSS/BLUE SHIELD
MD
Enumeration date
02/28/2007
Last updated
10/23/2024
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