Healthcare Provider Details

I. General information

NPI: 1114628237
Provider Name (Legal Business Name): SHARICE L RICHARD MPH, RD, LDN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/15/2023
Last Update Date: 03/15/2023
Certification Date: 03/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3040 33RD ST
METAIRIE LA
70001-2036
US

IV. Provider business mailing address

3040 33RD ST
METAIRIE LA
70001-2036
US

V. Phone/Fax

Practice location:
  • Phone: 504-896-3099
  • Fax:
Mailing address:
  • Phone: 504-896-3099
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133VN1004X
TaxonomyPediatric Nutrition Registered Dietitian
License Number2267
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: