DEDRA RICHARDSON (NPI# 1457801797) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457801797 |
| Entity Type | Individual |
| Full Name | DEDRA RICHARDSON |
| Credential | APRN |
| Practice Address |
65 Wal Mart Dr Mountain Home AR 72653-6784 |
| Mailing Address |
Po Box 422 Viola AR 72583-0422 |
| Practice Telephone | 8704922200 |
| Mailing Telephone | 8703711482 |
| Enumeration Date | 2016-10-11 |
| Last Update Date | 2016-10-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
A004927 | AR | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
65 WAL MART DR |
| City | MOUNTAIN HOME |
| State | AR |
| Zip Code | 72653-6784 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518984905 | Walmart Inc. | Durable Medical Equipment & Medical Supplies | 65 Wal Mart Dr, Mountain Home, AR 72653-6784 | 2006-07-16 |
| 1588264899 | Elisabeth Brooks | Pharmacist | 65 Wal Mart Dr, Mountain Home, AR 72653-6784 | 2020-10-27 |
| 1033688114 | Brett Brandon Sharp | Pharmacist | 65 Wal Mart Dr, Mountain Home, AR 72653-6784 | 2018-11-18 |
| 1093215840 | Jennifer Lambert | Nurse Practitioner | 65 Wal Mart Dr, Mountain Home, AR 72653-6784 | 2018-02-19 |
| 1861904377 | Ashton Jeanette Glenn | Nurse Practitioner | 65 Wal Mart Dr, Mountain Home, AR 72653-6784 | 2017-10-25 |
| 1679023824 | Darla Ann Johnston | Nurse Practitioner | 65 Wal Mart Dr, Mountain Home, AR 72653-6784 | 2016-10-12 |
| 1295105930 | William Keller | Nurse Practitioner | 65 Wal Mart Dr, Mountain Home, AR 72653-6784 | 2015-10-06 |
| 1871931006 | Langevin Eye Center P.a. | Optometrist | 65 Wal Mart Dr, Suite 8, Mountain Home, AR 72653-6784 | 2013-06-10 |
| 1205157427 | Baxter County Regional Hospital Inc | Nurse Practitioner | 65 Wal Mart Dr, Mountain Home, AR 72653-6784 | 2010-06-22 |
| 1740400472 | Michael A Langevin | Optometrist | 65 Wal Mart Dr, Suite 8, Mountain Home, AR 72653-6784 | 2007-04-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619513934 | Maranda Hickman | Physical Therapy Assistant | 347 Hwy 62 East College Plaza, Mountain Home, AR 72653 | 2019-11-21 |
| 1659929156 | Gale E Bacan | Technician | 1703 Monroe Ave, Mountain Home, AR 72653 | 2019-08-28 |
| 1891259321 | Kidspiration Pediatric Therapy Services | Clinic/Center | 710 Bradley Dr., Mountain Home, AR 72653 | 2019-01-29 |
| 1093279275 | Piper's Vision Xpress, LLC | Optometrist | 50 Paul Wood Lane, Mountian Home, AR 72653 | 2019-01-22 |
| 1346769155 | Heather Bollinger | Nurse Practitioner | 65 Walmart Drive, C/o Clinic At Walmart, Mountain Home, AR 72653 | 2017-09-12 |
| 1447774989 | Natalie D Ahrent | Physical Medicine & Rehabilitation | 804 Coley Dr, Mountain Home, AR 72653 | 2017-07-26 |
| 1417486028 | Andrew David Hatman | Case Manager/Care Coordinator | 1349 Hampshire Circle, Mountain Home, AR 72653 | 2017-06-07 |
| 1568848315 | Taylor Chiropractic Plc | Health Maintenance Organization | 103 S Main St Ste 5, Mountain Home, AR 72653 | 2015-08-04 |
| 1942606306 | Harps Food Stores, Inc | Pharmacy | 2089 Highway 62 West, Mountain Home, AR 72653 | 2014-11-13 |
| 1972920726 | Lavonne Armstrong | Counselor | 8 Medical Plaza, Mountain Home, AR 72653 | 2014-03-18 |
| Find all providers in zip 72653 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891346862 | Tosha Marie Applegate | Nurse Practitioner | 8606 Highway 201 N, Mountain Home, AR 72653-8291 | 2019-09-21 |
| 1831665744 | Cindy A Brown | Nurse Practitioner | 628 Hospital Dr Ste A, Mountain Home, AR 72653-2953 | 2018-10-17 |
| 1346769155 | Heather Bollinger | Nurse Practitioner | 65 Walmart Drive, C/o Clinic At Walmart, Mountain Home, AR 72653 | 2017-09-12 |
| 1740720598 | Cindy Conway | Nurse Practitioner | 809 Lamont Steet, Mountain Home, TN 37684 | 2017-02-27 |
| 1336695360 | Meredith Chapa | Nurse Practitioner | 405 Buttercup, Mountain Home, AR 72653-4838 | 2016-08-30 |
| 1477980191 | Hayley N Greer Adams | Nurse Practitioner | Moutain Home Va Healthcare System, Lamont & Veterans Way, Mountain Home, TN 37684-3768 | 2013-09-27 |
| 1760718514 | Preferred Medical Associates LLC | Nurse Practitioner | 40 Plaza Way, Suite 30, Mountain Home, AR 72653-9265 | 2009-10-29 |
| 1902038961 | Brandi Dawn Anderson | Nurse Practitioner | 628 Hospital Drive, Sutie 3a, Mountain Home, AR 72653 | 2009-08-10 |
| 1275665473 | Richard Fredrick Starkey Md | Nurse Practitioner | 806 North 6th East, Mountain Home, ID 83647-0427 | 2007-03-12 |
| 1699881698 | David Glenn Fulghum | Nurse Practitioner | 305 Highway 62 E, Mountain Home, AR 72653-3655 | 2006-08-22 |
| Find all providers in MOUNTAIN HOME | ||||
| City | MOUNTAIN HOME |
| Zip Code | 72653 |
Please comment or provide details below to improve the information on DEDRA RICHARDSON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.