Provider Demographics
NPI:1699115394
Name:RICHARDSON, ABBY E (MD AND APRN)
Entity type:Individual
Prefix:DR
First Name:ABBY
Middle Name:E
Last Name:RICHARDSON
Suffix:
Gender:F
Credentials:MD AND APRN
Other - Prefix:
Other - First Name:ABBY
Other - Middle Name:E
Other - Last Name:GERDES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:983075 NEBRASKA MEDICAL CTR
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68198-3075
Mailing Address - Country:US
Mailing Address - Phone:402-559-5641
Mailing Address - Fax:402-559-6501
Practice Address - Street 1:983075 NEBRASKA MEDICAL CTR
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68198-3075
Practice Address - Country:US
Practice Address - Phone:402-559-5641
Practice Address - Fax:402-559-6501
Is Sole Proprietor?:No
Enumeration Date:2013-06-27
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE8481207Q00000X
NE111513363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily