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NPI Code Detail

MEDICARE: MRS. MELINDA G RICHARDS FNP

MEDICARE: MRS. MELINDA G RICHARDS FNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse PractitionerR701246MS

General Provider Information

NPI Number : 1114084241
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MELINDA G RICHARDS FNP
Provider Business Mailing Address
First Line : 965 RIDGE LAKE BLVD STE 315
Second Line :
City : MEMPHIS
State : TN
Zip : 38120-9401
Country : US
Telephone Number :
Fax Number : 901-227-8591
Provider Business Practice Location Address
First Line : 823 GRAND AVE
Second Line :
City : YAZOO CITY
State : MS
Zip : 39194-3233
Country : US
Telephone Number : 662-751-8289
Fax Number : 662-751-8279
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/01/2007
Last Update Date : 08/05/2021

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