Individual
DAVEISHA JALYNN RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
755 WHITMAN ST, ORANGEBURG, SC 29115-6163
(803) 534-7036
Mailing address
5997 CAROLINA HIGHWAY, DENMARK, SC 29042
(803) 308-4716
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
29811
SC
Other
Enumeration date
05/27/2024
Last updated
01/24/2025
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