Provider Demographics
NPI:1992714208
Name:RICHARDSON, RENEE JOYCE (CNA)
Entity type:Individual
Prefix:
First Name:RENEE
Middle Name:JOYCE
Last Name:RICHARDSON
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46 TOWNER LN
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06478-1211
Mailing Address - Country:US
Mailing Address - Phone:203-888-6990
Mailing Address - Fax:
Practice Address - Street 1:46 TOWNER LN
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:CT
Practice Address - Zip Code:06478-1211
Practice Address - Country:US
Practice Address - Phone:203-888-6990
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide