MEDICARE: MS. NANCY MCLAUGHLIN RICHMOND PMHNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	364SP0808X	Psychiatric/Mental Health Clinical Nurse Specialist	2123	CA
2	363L00000X	Nurse Practitioner	15292	CA
3	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	15292	CA

General Provider Information

NPI Number	:	1770524761
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. NANCY MCLAUGHLIN RICHMOND PMHNP-BC

Provider Business Mailing Address
First Line	:	4750 LINCOLN BLVD
Second Line	:	APT 470
City	:	MARINA DEL REY
State	:	CA
Zip	:	90292-6900
Country	:	US
Telephone Number	:	949-307-4684
Fax Number	:

Provider Business Practice Location Address
First Line	:	4750 LINCOLN BLVD
Second Line	:	APT 470
City	:	MARINA DEL REY
State	:	CA
Zip	:	90292-6900
Country	:	US
Telephone Number	:	949-307-4684
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/09/2006
Last Update Date	:	10/22/2014

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