Provider Demographics
NPI:1881725521
Name:RICHARD, JOSEPH TERRY (RN)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:TERRY
Last Name:RICHARD
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1418 BOURBON ST
Mailing Address - Street 2:APT. B
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70116-2046
Mailing Address - Country:US
Mailing Address - Phone:504-949-2202
Mailing Address - Fax:
Practice Address - Street 1:210 STATE ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70118-5735
Practice Address - Country:US
Practice Address - Phone:504-897-4741
Practice Address - Fax:504-896-4918
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN065677163WP0807X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & Adolescent