Provider Demographics
NPI:1457649444
Name:RICHARDSON, ANNIE ABRAM (CNA)
Entity Type:Individual
Prefix:
First Name:ANNIE
Middle Name:ABRAM
Last Name:RICHARDSON
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11DOGWOOD DR PASS
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34472
Mailing Address - Country:US
Mailing Address - Phone:352-687-2214
Mailing Address - Fax:
Practice Address - Street 1:11 DOGWOOD DRIVE PASS
Practice Address - Street 2:11 DOGWOOD DR PASS
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34472-8027
Practice Address - Country:US
Practice Address - Phone:352-687-2214
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-12
Last Update Date:2011-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL31390376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide