Individual
PATRICIA L RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNNP
Contact information
Practice address
1541 KINGS HWY, SHREVEPORT, LA 71103-4228
(318) 626-0050
Mailing address
1512 W KIRBY PL, SHREVEPORT, LA 71103-3822
(318) 626-0287
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
AP04556
LA
363LN0000X
Neonatal Nurse Practitioner
Primary
AP04556
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
721648
LICENSE NUMBER
TX
Enumeration date
06/16/2006
Last updated
12/28/2022
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