Individual
RENITA TORQUISE RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1267 HIGHWAY 54 W STE 2200, FAYETTEVILLE, GA 30214-2110
(770) 716-0051
Mailing address
105 BASS PLANTATION DR APT 606, MACON, GA 31210-5754
(478) 737-4925
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN220240
GA
363LF0000X
Family Nurse Practitioner
RN220240
GA
Other
Enumeration date
04/04/2019
Last updated
07/28/2021
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