Provider Demographics
NPI:1245997857
Name:RICHARDS, NANETTE LANA (FNP)
Entity type:Individual
Prefix:
First Name:NANETTE
Middle Name:LANA
Last Name:RICHARDS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:NANETTE
Other - Middle Name:LANA
Other - Last Name:MOORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1605 FOX DR
Mailing Address - Street 2:
Mailing Address - City:MARTINSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46151-8213
Mailing Address - Country:US
Mailing Address - Phone:317-560-2225
Mailing Address - Fax:
Practice Address - Street 1:1605 FOX DR
Practice Address - Street 2:
Practice Address - City:MARTINSVILLE
Practice Address - State:IN
Practice Address - Zip Code:46151-8213
Practice Address - Country:US
Practice Address - Phone:317-560-2225
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-18
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
INF04210355363L00000X
IN71012013A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner