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General NPI Number Information
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NPI Number | 1457996613
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Entity Type | Individual
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Provider Name | LAUREN GRACE RICHARDS APN, PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 11/12/2019
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Last Update Date | 08/27/2024
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Provider Practice Location Address
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Address Line | 1 BETHANY RD STE 69
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City | HAZLET
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State | NJ
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Zip | 07730-1668
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Country | US
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Telephone | 732-784-8272
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Fax |
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Provider Business Mailing Address
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Address Line | 6 SPRING ST
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City | MATAWAN
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State | NJ
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Zip | 07747-3122
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Country | US
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Telephone | 732-570-8730
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 26NJ15122600
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License Number State | NJ
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