Provider Demographics
NPI:1720169535
Name:RICHARDS, ALICE J (RN)
Entity type:Individual
Prefix:MRS
First Name:ALICE
Middle Name:J
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 1:3009 OLD AUGUSTA RD
Mailing Address - Street 2:
Mailing Address - City:DEARING
Mailing Address - State:GA
Mailing Address - Zip Code:30808-4052
Mailing Address - Country:US
Mailing Address - Phone:706-597-1778
Mailing Address - Fax:
Practice Address - Street 1:6420 POLLARDS POND RD
Practice Address - Street 2:
Practice Address - City:APPLING
Practice Address - State:GA
Practice Address - Zip Code:30802-3726
Practice Address - Country:US
Practice Address - Phone:706-556-3727
Practice Address - Fax:706-556-9387
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN308811163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse