Individual
MRS. BETTY RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNFP
Contact information
Practice address
421 MARION AVE, MCCOMB, MS 39648-2709
(601) 684-6891
(601) 249-3834
Mailing address
1007 W CONGRESS ST, BROOKHAVEN, MS 39601-2603
(601) 833-9388
(601) 833-9495
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R135080
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00119592
—
MS
Enumeration date
05/09/2006
Last updated
08/12/2016
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