Provider Demographics
NPI:1548308372
Name:RICHARDSON, GAIL C (CNP)
Entity type:Individual
Prefix:
First Name:GAIL
Middle Name:C
Last Name:RICHARDSON
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:GAIL
Other - Middle Name:DENISE
Other - Last Name:CARR RICHARDSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:3495 PIEDMONT ROAD NE
Mailing Address - Street 2:NINE PIEDMONT CENTER
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30305-9775
Mailing Address - Country:US
Mailing Address - Phone:404-364-7000
Mailing Address - Fax:404-364-4752
Practice Address - Street 1:3495 PIEDMONT ROAD NE
Practice Address - Street 2:DEPARTMENT OF MEDICINE
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30305
Practice Address - Country:US
Practice Address - Phone:404-364-7000
Practice Address - Fax:404-364-4752
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2025-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN084949207R00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
50BBHXCMedicare ID - Type Unspecified
Q28634Medicare UPIN