Provider Demographics
NPI:1588554182
Name:RICHARD, HYLISHA RENEA
Entity type:Individual
Prefix:
First Name:HYLISHA
Middle Name:RENEA
Last Name:RICHARD
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 OSWALD ST
Mailing Address - Street 2:
Mailing Address - City:BREAUX BRIDGE
Mailing Address - State:LA
Mailing Address - Zip Code:70517-5044
Mailing Address - Country:US
Mailing Address - Phone:337-550-9162
Mailing Address - Fax:
Practice Address - Street 1:115 OSWALD ST
Practice Address - Street 2:
Practice Address - City:BREAUX BRIDGE
Practice Address - State:LA
Practice Address - Zip Code:70517-5044
Practice Address - Country:US
Practice Address - Phone:337-550-9162
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-07
Last Update Date:2025-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide