Provider Demographics
NPI:1285036665
Name:RICHARDS, WHITNEY LAREE (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:WHITNEY
Middle Name:LAREE
Last Name:RICHARDS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:MISS
Other - First Name:WHITNEY
Other - Middle Name:LAREE
Other - Last Name:PONDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:5012 S US HIGHWAY 75 STE 300
Mailing Address - Street 2:ATT: BILLING
Mailing Address - City:DENISON
Mailing Address - State:TX
Mailing Address - Zip Code:75020-4589
Mailing Address - Country:US
Mailing Address - Phone:903-416-6430
Mailing Address - Fax:
Practice Address - Street 1:5012 S US HIGHWAY 75
Practice Address - Street 2:SUITE 250
Practice Address - City:DENISON
Practice Address - State:TX
Practice Address - Zip Code:75020-4587
Practice Address - Country:US
Practice Address - Phone:903-416-6430
Practice Address - Fax:903-416-6431
Is Sole Proprietor?:No
Enumeration Date:2014-09-17
Last Update Date:2018-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP126439363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200651550AMedicaid
TX8280NYOtherBCBS OF TX
TX342423602Medicaid
OK200651550AMedicaid