| Doctor Name: | MRS. SHELLY SEBASTIEN RICHARD |
| NPI Number: | 1013291350 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | ANP,C |
| License Number: | RN100570-AP06654 |
| Business Practice Address: | 820 S Broadway St Church Point, LA - 705254402 |
| Business Phone Number: | 3376845232 |
| Business Fax Number: | |
| Mailing Address: | 820 S Broadway St, CHURCH POINT |
| State: | LA |
| Postal Code: | 705254402 |
| Phone Number: | 3376845232 |
| Fax Number: | |
| NPI Enumeration Date: | 10/05/2011 |
| NPI Last Update Date: | 10/05/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2200X |
| License Number: | RN100570-AP06654 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | LA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |