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General NPI Number Information
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NPI Number | 1629136221
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Entity Type | Individual
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Provider Name | CONNIE B RICHARDSON C.F.N.P.
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Gender | Female
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Dates
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Enumeration Date | 12/05/2006
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Last Update Date | 03/17/2025
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Provider Practice Location Address
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Address Line | 180B DEBUYS RD SUITE 223
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City | BILOXI
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State | MS
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Zip | 39531-4404
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Country | US
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Telephone | 228-388-4862
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Fax | 228-388-2556
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Provider Business Mailing Address
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Address Line | 117 BEACH PARK PL
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City | LONG BEACH
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State | MS
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Zip | 39560-6223
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Country | US
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Telephone | 228-214-3300
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Fax | 228-214-3344
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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 | 363LS0200X
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Taxonomy Name | School Nurse Practitioner
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License Number | R702226
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License Number State | MS
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