Melissa Sistrunk Richardson, FNPC
Nurse Practitioner in Logansport, LA. Individual provider (NPI-1).
NPI number1790750362
StatusActive
Last updated in NPPESMay 5, 2020
Details
- NPI
- 1790750362
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Melissa Sistrunk Richardson
- Credential
- FNPC
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Feb 17, 2006
- Certification date
- May 5, 2020
- Last updated
- May 5, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363L00000X | Nurse Practitioner | 520553482 | LA | Yes |
Practice location
808 Main StreetDesoto Regional Family Medicine
Logansport, LA 71049
Phone 318-697-2273 · Fax 318-697-2277
Mailing address
Po Box 789Logansport, LA 71049
Phone 318-697-2273 · Fax 318-697-2277
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