Individual
JANICE RENEA RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGNP
Contact information
Practice address
1350 E LANCASTER AVE STE 100, FORT WORTH, TX 76102-6671
(817) 702-8391
(817) 702-4102
Mailing address
PO BOX 40411, BELFAST, ME 04915-1255
(972) 870-5511
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
AP117208
TN
363LA2200X
Adult Health Nurse Practitioner
Primary
AP117208
TX
363LG0600X
Gerontology Nurse Practitioner
601924
TX
363LP2300X
Primary Care Nurse Practitioner
601924
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
340549001
—
TX
05
—
340549003
—
TX
01
—
8445NJ
BCBS
TX
01
—
8920NK
BCBS
TX
Enumeration date
03/07/2012
Last updated
09/23/2025
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