Provider Demographics
NPI:1710233267
Name:RICHARDSON, WHITTNEY LANE (NP)
Entity Type:Individual
Prefix:
First Name:WHITTNEY
Middle Name:LANE
Last Name:RICHARDSON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:WHITTNEY
Other - Middle Name:LANE
Other - Last Name:BLOUNT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP-C
Mailing Address - Street 1:300 N HIGHLAND AVE
Mailing Address - Street 2:SUITE 315
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75092-7388
Mailing Address - Country:US
Mailing Address - Phone:903-821-8156
Mailing Address - Fax:
Practice Address - Street 1:142 ARTHUR RD
Practice Address - Street 2:
Practice Address - City:DENISON
Practice Address - State:TX
Practice Address - Zip Code:75021-4282
Practice Address - Country:US
Practice Address - Phone:903-821-8156
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-01
Last Update Date:2015-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX741294363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX741294OtherBOARD OF NURSING