Provider Demographics
NPI:1568590560
Name:RICHARDSON, KAREN DENISE (BS)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:DENISE
Last Name:RICHARDSON
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:321 W 7TH ST
Mailing Address - Street 2:PO BOX 1197
Mailing Address - City:COLUMBIA
Mailing Address - State:TN
Mailing Address - Zip Code:38401-3132
Mailing Address - Country:US
Mailing Address - Phone:931-490-1421
Mailing Address - Fax:931-490-1402
Practice Address - Street 1:321 W 7TH ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:TN
Practice Address - Zip Code:38401-3132
Practice Address - Country:US
Practice Address - Phone:931-490-1421
Practice Address - Fax:931-490-1402
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator