Individual provider · Type 1 NPI

Tierra Shanel Richardson

Gerontology Nurse Practitioner · Bowie, MD

NPI number 1740796945 Active

Practice location

14300 Gallant Fox Ln
Bowie, MD 20715-4003

Mailing address

15616 Burford Ln
Upper Marlboro, MD 20774-8410

Other practice locations

  • 14300 Gallant Fox Ln, Bowie, MD 20715-4003 · (301) 805-4348

Specialties and licenses

TaxonomyCodeLicense
Gerontology Nurse Practitioner Primary 363LG0600XR20340 (MD)

Gerontology Nurse Practitioner: Definition to come...

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About NPI 1740796945

Tierra Shanel Richardson's National Provider Identifier is 1740796945, issued on Dec 26, 2017. The primary taxonomy on file is Gerontology Nurse Practitioner (363LG0600X), and the practice location is in Bowie, MD. The record was last updated on Jun 14, 2022.