Individual
JESSICA LYNN RICHARDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
877 JEFFERSON AVE, MEMPHIS, TN 38103-2807
(901) 545-7100
Mailing address
5929 MATTEW DR, HORN LAKE, MS 38637-8723
(901) 482-0903
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
138930
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
F01191338
AANCP
—
Enumeration date
02/05/2019
Last updated
06/25/2024
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