Provider Demographics
NPI:1851662639
Name:RICHARDSON, ZIONISHA NICOLE
Entity Type:Individual
Prefix:
First Name:ZIONISHA
Middle Name:NICOLE
Last Name:RICHARDSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7251 W LAKE MEAD BLVD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-0274
Mailing Address - Country:US
Mailing Address - Phone:702-562-4096
Mailing Address - Fax:702-562-4092
Practice Address - Street 1:7251 W LAKE MEAD BLVD
Practice Address - Street 2:SUITE 300
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-0274
Practice Address - Country:US
Practice Address - Phone:702-562-4096
Practice Address - Fax:702-562-4092
Is Sole Proprietor?:No
Enumeration Date:2012-01-25
Last Update Date:2012-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant