Individual
JEROME RICHARD JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PMHNP-BC
Contact information
Practice address
23450 EDEN ST, PLAQUEMINE, LA 70764-2528
(225) 614-2857
(225) 452-9079
Mailing address
4540 FORET ST, ADDIS, LA 70710-2553
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
RN141212
LA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
242512
LA
Other
Enumeration date
01/17/2025
Last updated
10/03/2025
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