Provider Demographics
NPI:1083749493
Name:RICHEY, REBECCA J (RN, FNP)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:J
Last Name:RICHEY
Suffix:
Gender:F
Credentials:RN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 23RD AVE N
Mailing Address - Street 2:ROOM 116
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-1503
Mailing Address - Country:US
Mailing Address - Phone:615-340-5337
Mailing Address - Fax:
Practice Address - Street 1:311 23RD AVE N
Practice Address - Street 2:ROOM 116
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-1503
Practice Address - Country:US
Practice Address - Phone:615-340-5337
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2009-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN0000041641163WC1500X
TNAPN0000005326363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3348941Medicaid