Provider Demographics
NPI:1750911970
Name:RICHARDS, ANGELA (RN)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:RICHARDS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3963 WHIPPER BARONY LN
Mailing Address - Street 2:
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29405-7162
Mailing Address - Country:US
Mailing Address - Phone:843-740-1580
Mailing Address - Fax:
Practice Address - Street 1:3963 WHIPPER BARONY LN
Practice Address - Street 2:
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29405-7162
Practice Address - Country:US
Practice Address - Phone:843-740-1580
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-16
Last Update Date:2020-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3700163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health