Provider Demographics
NPI:1932955416
Name:RICHARDSON, LYONDA (HHA,MA,CNA)
Entity Type:Individual
Prefix:MS
First Name:LYONDA
Middle Name:
Last Name:RICHARDSON
Suffix:
Gender:F
Credentials:HHA,MA,CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2215 LAUREL OAK DR
Mailing Address - Street 2:
Mailing Address - City:VALRICO
Mailing Address - State:FL
Mailing Address - Zip Code:33596-5258
Mailing Address - Country:US
Mailing Address - Phone:813-328-0895
Mailing Address - Fax:
Practice Address - Street 1:2215 LAUREL OAK DR
Practice Address - Street 2:
Practice Address - City:VALRICO
Practice Address - State:FL
Practice Address - Zip Code:33596-5258
Practice Address - Country:US
Practice Address - Phone:813-328-0895
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-25
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide