Individual
DEVON JERMAINE RICHARDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
611 ETHERIDGE ST, HUMBOLDT, TN 38343-2357
(731) 326-2705
Mailing address
611 ETHERIDGE ST, HUMBOLDT, TN 38343-2357
(731) 326-2705
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
149496
TN
Other
Enumeration date
10/10/2022
Last updated
10/10/2022
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