Provider Demographics
NPI:1588048987
Name:RICHARDSON, BRITTANY NICOLE (LPN)
Entity type:Individual
Prefix:MRS
First Name:BRITTANY
Middle Name:NICOLE
Last Name:RICHARDSON
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MS
Other - First Name:BRITTANY
Other - Middle Name:NICOLE
Other - Last Name:PHILLIPS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:54 LORIMER ST
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14608-1135
Mailing Address - Country:US
Mailing Address - Phone:585-857-0116
Mailing Address - Fax:
Practice Address - Street 1:54 LORIMER ST
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14608-1135
Practice Address - Country:US
Practice Address - Phone:585-857-0116
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-15
Last Update Date:2015-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY10-320282164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse