Provider Demographics
NPI:1649040528
Name:RICHARDS, SHYRA LEIGH (PMHNP)
Entity type:Individual
Prefix:
First Name:SHYRA
Middle Name:LEIGH
Last Name:RICHARDS
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4833 RUGBY AVE STE 400
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-3915
Mailing Address - Country:US
Mailing Address - Phone:301-381-8381
Mailing Address - Fax:
Practice Address - Street 1:6861 ELM ST STE 3E
Practice Address - Street 2:
Practice Address - City:MC LEAN
Practice Address - State:VA
Practice Address - Zip Code:22101-6036
Practice Address - Country:US
Practice Address - Phone:301-381-8381
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-03
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024188996363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health