Individual
JENNIFER RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NNP
Contact information
Practice address
1991 LAKELAND DR STE C, JACKSON, MS 39216-5000
(601) 981-5887
(601) 981-7935
Mailing address
1991 LAKELAND DR STE C, JACKSON, MS 39216-5000
(601) 981-5887
(601) 981-7935
Taxonomy
Speciality
Code
Description
License number
State
363LN0005X
Critical Care Neonatal Nurse Practitioner
Primary
R855650
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06939583
—
MS
Enumeration date
06/17/2008
Last updated
06/12/2012
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