Provider Demographics
NPI:1265700488
Name:RICHARDSON, KATRINA DANIELLE (RN, CNP)
Entity type:Individual
Prefix:
First Name:KATRINA
Middle Name:DANIELLE
Last Name:RICHARDSON
Suffix:
Gender:F
Credentials:RN, CNP
Other - Prefix:
Other - First Name:KATRINA
Other - Middle Name:DANIELLE
Other - Last Name:LEWIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, CNP
Mailing Address - Street 1:3333 BURNET AVE., ML 7015
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45229-3039
Mailing Address - Country:US
Mailing Address - Phone:513-803-7987
Mailing Address - Fax:513-636-6658
Practice Address - Street 1:3333 BURNET AVE., ML 7015
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229-3039
Practice Address - Country:US
Practice Address - Phone:513-636-4266
Practice Address - Fax:513-636-3549
Is Sole Proprietor?:No
Enumeration Date:2011-12-02
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA.12848-NP363LA2100X
OHAPRN.CNP.12848363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care