Healthcare Provider Details

I. General information

NPI: 1194768515
Provider Name (Legal Business Name): CINDY RICHARDS APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/14/2006
Last Update Date: 04/02/2020
Certification Date: 04/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

523 ESPLANADE ST
LAFAYETTE LA
70508-3121
US

IV. Provider business mailing address

523 ESPLANADE ST
LAFAYETTE LA
70508-3121
US

V. Phone/Fax

Practice location:
  • Phone: 337-278-7183
  • Fax:
Mailing address:
  • Phone: 337-278-7183
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP03504
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: