Individual
TIFFANY AMBER RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
WHNP-BC
Contact information
Practice address
2316 SOUTH ST, LAFAYETTE, IN 47904-2971
(765) 742-1567
Mailing address
1716 HARTFORD ST, LAFAYETTE, IN 47904-2138
(765) 742-1567
(765) 429-2700
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
71012889A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
71012889A
LICENSE
IN
Enumeration date
07/14/2022
Last updated
06/15/2023
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