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Individual

MISS MEREDITH TATE RICHARDSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
2000 E LAMAR BLVD STE 400, ARLINGTON, TX 76006-7353
(901) 378-2280
Mailing address
2000 E LAMAR BLVD STE 400, ARLINGTON, TX 76006-7353

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
144047
TN
367500000X
Certified Registered Nurse Anesthetist
Primary
15874
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1053603423
CHAMPUS/TRICARE
01
4296474
BCBS
TN
Enumeration date
05/04/2011
Last updated
07/24/2014
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