Individual
NIEASHA LANISE RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
9894 E 121ST ST, FISHERS, IN 46037-4154
(317) 621-2273
(317) 806-1653
Mailing address
6626 E 75TH ST STE 500, INDIANAPOLIS, IN 46250-2890
(317) 621-9312
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71003015A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200954040
—
IN
01
—
P01588235
RR MEDICARE
IN
Enumeration date
08/31/2009
Last updated
02/02/2021
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