Provider Demographics
NPI:1407892136
Name:RICHARDSON, LUANN G (CRNP)
Entity type:Individual
Prefix:
First Name:LUANN
Middle Name:G
Last Name:RICHARDSON
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8150 PERRY HWY STE 201
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15237-5200
Mailing Address - Country:US
Mailing Address - Phone:412-364-4402
Mailing Address - Fax:412-364-8037
Practice Address - Street 1:8150 PERRY HWY STE 101
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15237-5232
Practice Address - Country:US
Practice Address - Phone:412-364-2664
Practice Address - Fax:412-364-8037
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PANP012881363LP0808X
PASP001343B363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA362219OtherKEYSTONE HEALTH PLAN WEST
PASP012881OtherCOMMONWEALTH OF PENNSYLVANIA BUREAU OF PROFESSIONAL AND OCCUPATIONAL AFFAIRS
PASP001343BOtherCOMMONWEALTH OF PENNSYLVANIA BUREAU OF PROFESSIONAL AND OCCUPATIONAL AFFAIRS