Provider Demographics
NPI:1932238458
Name:RICHARDSON, DIANA HUFSTEDLER (RNC)
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:HUFSTEDLER
Last Name:RICHARDSON
Suffix:
Gender:F
Credentials:RNC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 MEDICAL DR
Mailing Address - Street 2:
Mailing Address - City:LINDEN
Mailing Address - State:TN
Mailing Address - Zip Code:37096-3326
Mailing Address - Country:US
Mailing Address - Phone:931-589-2138
Mailing Address - Fax:931-589-5414
Practice Address - Street 1:31 MEDICAL DR
Practice Address - Street 2:
Practice Address - City:LINDEN
Practice Address - State:TN
Practice Address - Zip Code:37096-3326
Practice Address - Country:US
Practice Address - Phone:931-589-2138
Practice Address - Fax:931-589-5414
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000011450163WW0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WW0101XNursing Service ProvidersRegistered NurseWomen's Health Care, Ambulatory