Provider Demographics
NPI:1801169784
Name:RICHARDSON, KARISSA J (RN)
Entity type:Individual
Prefix:MRS
First Name:KARISSA
Middle Name:J
Last Name:RICHARDSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:826 PRISCILLA LN
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23322-3719
Mailing Address - Country:US
Mailing Address - Phone:757-410-7293
Mailing Address - Fax:
Practice Address - Street 1:826 PRISCILLA LN
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23322-3719
Practice Address - Country:US
Practice Address - Phone:757-410-7293
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-22
Last Update Date:2012-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001205045163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics