Healthcare Provider Details

I. General information

NPI: 1497570337
Provider Name (Legal Business Name): SANDRA RICHARDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/16/2024
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 JOHNSON FERRY RD STE 600
ATLANTA GA
30342-1739
US

IV. Provider business mailing address

1835 SAVOY DR STE 203
ATLANTA GA
30341-1073
US

V. Phone/Fax

Practice location:
  • Phone: 404-256-4777
  • Fax:
Mailing address:
  • Phone: 770-496-9430
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN128951
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberRN128951
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: