Melissa Sistrunk Richardson, FNPC
Individual provider Active NPI Nurse Practitioner · Logansport, LA
NPI 1790750362 · NPPES record last updated May 5, 2020
Key facts
- NPI
- 1790750362
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 520553482 (LA)
- Practice address
- 808 Main Street
Desoto Regional Family Medicine
Logansport, LA 71049 - Phone
- (318) 697-2273
- Fax
- (318) 697-2277
- NPI assigned
- Feb 17, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 520553482 | LA | MD | Nurse Practitioner |
Interoperability endpoints
- melissa.richardson@drfmc.eclinicaldirectplus.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 520553482 | LA | Yes |
Addresses
Primary practice location
808 Main Street
Desoto Regional Family Medicine
Logansport, LA 71049
Mailing address
PO Box 789
Logansport, LA 71049
Phone (318) 697-2273
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1553611 | Medicaid | LA |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | Melissa.richardson@drfmc.eclinicaldirectplus.com |
Other providers in Logansport, LA
- Talisha Parks
- Joseph Peoples
- Sonja Smith Polley
- Red River Pharmacy Consulting, LLC
- Red River Pharmacy Consulting, LLC
- Octavia Paulette Richardson
- Felicia W Ross
- Shomichael Stephens
- Robert Edwin Toner III
- Victoria Nichole Wilson
All providers in Logansport, LA · Nurse Practitioner in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 5, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.