Richardson, Lisa

Richardson, Lisa is an individual health care provider with primary practice located at 1681 Eagle Harbor Pkwy Ste B , Fleming Island FL 32003-4819. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Richardson, Lisa can be contacted via phone (904) 644-0092.

Contact Information

Primary practice address
1681 Eagle Harbor Pkwy Ste B Fleming Island FL 32003-4819
Phone: (904) 644-0092
Fax: (904) 644-0099
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X APRN3165542 Florida

Profile Details

NPI number 1922168491
LBN Legal business name Richardson, Lisa
Credentials Advanced Practice Registered Nurse (APRN)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 12th, 2006
Last updated Jan 27th, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1922168491 NPPES
Florida Other Y05WA BCBS

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