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General NPI Number Information
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NPI Number | 1154840296
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Entity Type | Individual
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Provider Name | RICHKARD SAINT LOUIS
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Gender | Male
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Dates
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Enumeration Date | 09/10/2017
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Last Update Date | 09/25/2024
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Provider Practice Location Address
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Address Line | CLARK HEALTH CLINIC WOMACK 5-4257 BASTONGE ST
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City | FORT LIBERTY
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State | NC
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Zip | 28310-9098
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Country | US
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Telephone | 910-907-2575
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Fax | 910-907-9606
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Provider Business Mailing Address
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Address Line | 207 SE 4TH AVE
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City | DELRAY BEACH
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State | FL
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Zip | 33483-4517
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Country | US
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Telephone | 561-713-3856
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | ARNP9384988
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License Number State | FL
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