MEDICARE: ATTRICE RICHARDS

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
1	363LF0000X	Family Nurse Practitioner	F02241153	AR

General Provider Information

NPI Number	:	1124885553
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ATTRICE RICHARDS

Provider Business Mailing Address
First Line	:	PO BOX 6752
Second Line	:
City	:	SILOAM SPRINGS
State	:	AR
Zip	:	72761-6752
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3609 N ROBIN CT
Second Line	:
City	:	SILOAM SPRINGS
State	:	AR
Zip	:	72761-9266
Country	:	US
Telephone Number	:	417-483-7758
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/04/2024
Last Update Date	:	03/04/2024

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Directions to “ ATTRICE RICHARDS ” Practice Location

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