Provider Demographics
NPI:1962498469
Name:RICHEY, JOSCELYN FELDER (ARNP)
Entity Type:Individual
Prefix:
First Name:JOSCELYN
Middle Name:FELDER
Last Name:RICHEY
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 E FLETCHER AVE
Mailing Address - Street 2:SUITE 350
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33613-4656
Mailing Address - Country:US
Mailing Address - Phone:813-977-5557
Mailing Address - Fax:813-972-9211
Practice Address - Street 1:3000 E FLETCHER AVE
Practice Address - Street 2:SUITE 350
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33613-4656
Practice Address - Country:US
Practice Address - Phone:813-977-5557
Practice Address - Fax:813-972-9211
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-21
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1904402363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK0668Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER
FLS33787Medicare UPIN
FLY5925ZMedicare ID - Type UnspecifiedINDIVIDUAL MEDICARE NUMBE