Richardson, Connie B
Richardson, Connie B is an sole proprietor health care provider with primary practice located at 180B Debuys Rd Suite 223, Biloxi MS 39531-4404. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Richardson, Connie B can be contacted via phone (228) 388-4862.Contact Information
Primary practice address
180B Debuys Rd Suite 223
Biloxi MS 39531-4404
Phone: (228) 388-4862
Fax: (228) 388-2556
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner | 363L00000X | R702226 | Mississippi |
Profile Details
| NPI number | 1629136221 |
|---|---|
| LBN Legal business name | Richardson, Connie B |
| Credentials | Certified Family Nurse Practitioner (CFNP) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 5th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1629136221 | NPPES |
| Mississippi | Other | 640654841 | TRICARE FOR LIFE |
| Mississippi | MEDICAID | 00123168 | TRICARE FOR LIFE |
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