Individual
GLENDA JOHNSON RICHARDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2100 3RD STREET, SUITE 6, KENNER, LA 70062-7600
(566) 125-1044
(504) 466-2014
Mailing address
43 ELWOOD DR., DESTREHAN, LA 70047-3703
(504) 466-1251
(504) 466-2014
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
014496
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1301922
—
LA
Enumeration date
01/08/2007
Last updated
07/08/2007
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