Provider Demographics
NPI:1780577650
Name:RICHARDSON, STEFANIE NICOLE
Entity type:Individual
Prefix:
First Name:STEFANIE
Middle Name:NICOLE
Last Name:RICHARDSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30600 AURORA RD STE 100
Mailing Address - Street 2:
Mailing Address - City:SOLON
Mailing Address - State:OH
Mailing Address - Zip Code:44139-2766
Mailing Address - Country:US
Mailing Address - Phone:440-850-0609
Mailing Address - Fax:
Practice Address - Street 1:30600 AURORA RD STE 100
Practice Address - Street 2:
Practice Address - City:SOLON
Practice Address - State:OH
Practice Address - Zip Code:44139-2766
Practice Address - Country:US
Practice Address - Phone:440-850-0609
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-30
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health