Provider Demographics
NPI:1023731064
Name:RICHARDSON, JESSICA LYNNE (DPT)
Entity type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:LYNNE
Last Name:RICHARDSON
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2269 ABBEYWOOD RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40515-1112
Mailing Address - Country:US
Mailing Address - Phone:859-705-2363
Mailing Address - Fax:
Practice Address - Street 1:1792 ALYSHEBA WAY STE 140
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-2289
Practice Address - Country:US
Practice Address - Phone:859-264-9249
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-23
Last Update Date:2025-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN14172225100000X
TX1369040225100000X
KY009421225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist