Individual
SHELLIE RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CSFA
Contact information
Practice address
8080 BLUEBONNET BLVD, BATON ROUGE, LA 70810-7827
(225) 924-2424
Mailing address
6505 AUDUBON BLVD, SORRENTO, LA 70778-3439
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
172692
LA
Other
Enumeration date
06/15/2017
Last updated
06/15/2017
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