Provider Demographics
NPI:1245784818
Name:RICHARDSON, LORRIE (APN)
Entity Type:Individual
Prefix:
First Name:LORRIE
Middle Name:
Last Name:RICHARDSON
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4805 COLUMBIA PIKE
Mailing Address - Street 2:
Mailing Address - City:THOMPSONS STATION
Mailing Address - State:TN
Mailing Address - Zip Code:37179-5207
Mailing Address - Country:US
Mailing Address - Phone:615-791-0974
Mailing Address - Fax:
Practice Address - Street 1:4805 COLUMBIA PIKE
Practice Address - Street 2:
Practice Address - City:THOMPSONS STATION
Practice Address - State:TN
Practice Address - Zip Code:37179-5207
Practice Address - Country:US
Practice Address - Phone:615-791-0974
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-11
Last Update Date:2021-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN21593363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily