Provider Demographics
NPI:1427385004
Name:RICHEY, BRIAN F (FNP-BC)
Entity Type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:F
Last Name:RICHEY
Suffix:
Gender:M
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:978 RIVER BEND DR
Mailing Address - Street 2:
Mailing Address - City:COOKEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38506-5972
Mailing Address - Country:US
Mailing Address - Phone:615-268-9040
Mailing Address - Fax:931-651-2202
Practice Address - Street 1:5221 RAVENS GLN
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37211-8596
Practice Address - Country:US
Practice Address - Phone:615-354-7839
Practice Address - Fax:615-831-0187
Is Sole Proprietor?:No
Enumeration Date:2009-11-03
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN14453363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
12061020OtherCAQH UPD
TN1521341Medicaid
TN103I505725Medicare PIN