Individual
TIFFANY LYNN RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
1107 CROWN POINTE DR, SUITE C, ELIZABETHTOWN, KY 42701-7123
(270) 982-1200
(270) 234-1952
Mailing address
PO BOX 2119, ELIZABETHTOWN, KY 42702-2119
(270) 982-1200
(270) 234-1952
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5799P
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000593282
ANTHEM BCBS
—
05
—
7100064850
—
KY
Enumeration date
11/06/2008
Last updated
11/08/2013
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