Individual
MISS LAMANTHA RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CFNP
Contact information
Practice address
1547 WARRIOR DR, MURFREESBORO, TN 37128-0921
(615) 941-8538
Mailing address
2332 SCULLING ST, MURFREESBORO, TN 37129-3293
(817) 253-8351
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
762390
TX
363LP2300X
Primary Care Nurse Practitioner
Primary
32028
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PKEY 383717421
HEALTH NET (TRICARE)
MI
01
—
PKEY-383717421
HEALTH NET (TRICARE)
TX
01
—
Q76136
MEDICARE UPIN
TX
Enumeration date
01/09/2007
Last updated
10/25/2022
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