Provider Demographics
NPI:1538057534
Name:RICHARDSON, EARNESTINE PRINCESS (PROVIDER)
Entity type:Individual
Prefix:
First Name:EARNESTINE
Middle Name:PRINCESS
Last Name:RICHARDSON
Suffix:
Gender:F
Credentials:PROVIDER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 GLENDALE ST APT 134
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33803-4022
Mailing Address - Country:US
Mailing Address - Phone:678-349-8782
Mailing Address - Fax:
Practice Address - Street 1:140 GLENDALE ST APT 134
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33803-4022
Practice Address - Country:US
Practice Address - Phone:678-349-8782
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-26
Last Update Date:2025-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health