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Individual

MRS. LESLEY NICOLE RICHARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MBA, MNA, CRNA

Contact information

Practice address
1910 BLANDING ST, COLUMBIA, SC 29201-3520
(803) 256-4107
Mailing address
1429 TAMARIND LN, CHAPIN, SC 29036-6324
(386) 288-4529

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
243523
SC
367500000X
Certified Registered Nurse Anesthetist
Primary
26136
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
AN3702
SC
Enumeration date
06/01/2021
Last updated
05/08/2023
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