Provider Demographics
NPI:1881052314
Name:RICHARDSON, KARLIN (APRN)
Entity type:Individual
Prefix:
First Name:KARLIN
Middle Name:
Last Name:RICHARDSON
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 N 5TH ST
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71201-5317
Mailing Address - Country:US
Mailing Address - Phone:318-512-4997
Mailing Address - Fax:318-600-6095
Practice Address - Street 1:1201 N 5TH ST
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-5317
Practice Address - Country:US
Practice Address - Phone:318-325-8129
Practice Address - Fax:318-600-6095
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-28
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN107776163W00000X
LA228990363LP0808X
103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst