Individual
MRS. KRYSTEN LEEANN RICHARDSON
Active
Individual
MRS. KRYSTEN LEEANN RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
3576
TN
363AM0700X
Medical Physician Assistant
Primary
1346
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
267297
—
AL
05
—
Q037209
—
TN
Enumeration date
06/25/2018
Last updated
09/01/2021
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