Provider Demographics
NPI:1538209176
Name:RICHARDSON, MARY ANNE (CPM, EMT-IV)
Entity type:Individual
Prefix:MRS
First Name:MARY
Middle Name:ANNE
Last Name:RICHARDSON
Suffix:
Gender:F
Credentials:CPM, EMT-IV
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:613 SHADYCREST LN
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37064-5110
Mailing Address - Country:US
Mailing Address - Phone:615-791-6645
Mailing Address - Fax:615-595-1018
Practice Address - Street 1:613 SHADYCREST LN
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37064-5110
Practice Address - Country:US
Practice Address - Phone:615-791-6645
Practice Address - Fax:615-595-1018
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000000006176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife