Provider Demographics
NPI:1083478903
Name:RICHARDSON, ASHLEE (NP-C)
Entity Type:Individual
Prefix:
First Name:ASHLEE
Middle Name:
Last Name:RICHARDSON
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12207 E 214TH ST
Mailing Address - Street 2:
Mailing Address - City:PECULIAR
Mailing Address - State:MO
Mailing Address - Zip Code:64078-8324
Mailing Address - Country:US
Mailing Address - Phone:913-548-9038
Mailing Address - Fax:
Practice Address - Street 1:8675 COLLEGE BLVD STE 100
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66210-1863
Practice Address - Country:US
Practice Address - Phone:913-345-9400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-12
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2024004218363LF0000X
KS53-82873-052363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily