Provider Demographics
NPI:1598759268
Name:RICHARDSON, JDEE KATHRYN (PHD, ARNP)
Entity Type:Individual
Prefix:MS
First Name:JDEE
Middle Name:KATHRYN
Last Name:RICHARDSON
Suffix:
Gender:F
Credentials:PHD, ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2700 VISSING PARK RD
Mailing Address - Street 2:
Mailing Address - City:JEFFERSONVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47130-5989
Mailing Address - Country:US
Mailing Address - Phone:812-284-8000
Mailing Address - Fax:812-258-1094
Practice Address - Street 1:2700 VISSING PARK RD
Practice Address - Street 2:
Practice Address - City:JEFFERSONVILLE
Practice Address - State:IN
Practice Address - Zip Code:47130-5989
Practice Address - Country:US
Practice Address - Phone:812-284-8000
Practice Address - Fax:812-258-1094
Is Sole Proprietor?:No
Enumeration Date:2005-09-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71001922363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner