Provider Demographics
NPI:1164228235
Name:RICHARDSON, BRYSON EUGENE
Entity type:Individual
Prefix:MR
First Name:BRYSON
Middle Name:EUGENE
Last Name:RICHARDSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 4TH ST
Mailing Address - Street 2:
Mailing Address - City:DAWSON
Mailing Address - State:NE
Mailing Address - Zip Code:68337-4041
Mailing Address - Country:US
Mailing Address - Phone:402-802-1777
Mailing Address - Fax:
Practice Address - Street 1:303 4TH ST
Practice Address - Street 2:
Practice Address - City:DAWSON
Practice Address - State:NE
Practice Address - Zip Code:68337-4041
Practice Address - Country:US
Practice Address - Phone:402-802-1777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-20
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No372500000XNursing Service Related ProvidersChore Provider
No372600000XNursing Service Related ProvidersAdult Companion