Provider Demographics
NPI:1447370317
Name:RICHARDSON, JAMES N JR (APNC, RNFA, CNOR)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:N
Last Name:RICHARDSON
Suffix:JR
Gender:M
Credentials:APNC, RNFA, CNOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:433 NIGHTINGALE SQ
Mailing Address - Street 2:
Mailing Address - City:MAYS LANDING
Mailing Address - State:NJ
Mailing Address - Zip Code:08330-5603
Mailing Address - Country:US
Mailing Address - Phone:609-646-6025
Mailing Address - Fax:609-646-6316
Practice Address - Street 1:433 NIGHTINGALE SQ
Practice Address - Street 2:
Practice Address - City:MAYS LANDING
Practice Address - State:NJ
Practice Address - Zip Code:08330-5603
Practice Address - Country:US
Practice Address - Phone:609-646-6025
Practice Address - Fax:609-646-6316
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NO10486300163WR0006X
NJ26NJ00054400363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant
Not Answered363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0070688Medicaid
NJ091065N7JMedicare ID - Type Unspecified
NJQ43898Medicare UPIN