Provider Demographics
NPI:1528692795
Name:RICHARDS, SHIRMEL T (DNP, APRN)
Entity type:Individual
Prefix:DR
First Name:SHIRMEL
Middle Name:T
Last Name:RICHARDS
Suffix:
Gender:F
Credentials:DNP, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1696 SE HILLMOOR DR STE A
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34952-7699
Mailing Address - Country:US
Mailing Address - Phone:772-692-2023
Mailing Address - Fax:772-692-1555
Practice Address - Street 1:1696 SE HILLMOOR DR STE A
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34952-7699
Practice Address - Country:US
Practice Address - Phone:772-692-2023
Practice Address - Fax:772-692-1555
Is Sole Proprietor?:No
Enumeration Date:2020-02-26
Last Update Date:2021-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11006315363L00000X, 363LA2200X, 363LG0600X, 363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology