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Individual

TAMARA RICHARDSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
260 FAIRWINDS RD, LANDRUM, SC 29356-9075
(864) 473-7058
Mailing address
260 FAIRWINDS RD, LANDRUM, SC 29356-9075
(864) 473-7058

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
25144
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
NP7641
SC
01
SCK4925206
MEDICARE PIN
SC
Enumeration date
06/29/2021
Last updated
06/28/2023
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