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Individual

MRS. CONNIE B RICHARDSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
C.F.N.P.

Contact information

Practice address
180B DEBUYS RD, SUITE 223, BILOXI, MS 39531-4404
(228) 388-4862
(228) 388-2556
Mailing address
117 BEACH PARK PL, LONG BEACH, MS 39560-6223
(228) 214-3300
(228) 214-3344

Taxonomy

Speciality
Code
Description
License number
State
363LS0200X
School Nurse Practitioner
Primary
R702226
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00123168
MS
01
640654841
TRICARE FOR LIFE
MS
Enumeration date
12/05/2006
Last updated
03/17/2025
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