Individual
MRS. CAMILLE C RICHARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
2500 NORTH STATE STREET, JACKSON, MS 39216-4500
(601) 984-5678
(601) 984-5638
Mailing address
2500 NORTH STATE STREET, JACKSON, MS 39216-4500
(601) 984-5678
(601) 984-5638
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R869001
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04507070
—
MS
Enumeration date
12/22/2006
Last updated
11/14/2016
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