Doctor Name: | MRS. DONNA MARIE RICHARDSON |
NPI Number: | 1063520682 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NP |
License Number: | |
Business Practice Address: | 2495 Shreveport Hwy 71 N Pineville, LA - 713609004 |
Business Phone Number: | 3184730010 |
Business Fax Number: | 3184835072 |
Mailing Address: | Po Box 17874, NATCHEZ |
State: | MS |
Postal Code: | 391227874 |
Phone Number: | 6014450907 |
Fax Number: | |
NPI Enumeration Date: | 08/25/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LA2200X |
License Number: | |
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: |