Provider Demographics
NPI:1447982913
Name:RICHARDS, VICTORIA ROSE (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:VICTORIA
Middle Name:ROSE
Last Name:RICHARDS
Suffix:
Gender:
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 PAT HARALSON DR UNIT 1
Mailing Address - Street 2:
Mailing Address - City:BLAIRSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30512-8454
Mailing Address - Country:US
Mailing Address - Phone:706-745-8790
Mailing Address - Fax:
Practice Address - Street 1:401 PAT HARALSON DR UNIT 1
Practice Address - Street 2:
Practice Address - City:BLAIRSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30512-8454
Practice Address - Country:US
Practice Address - Phone:706-745-8790
Practice Address - Fax:706-745-8842
Is Sole Proprietor?:No
Enumeration Date:2022-06-24
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5016835363LF0000X
FL11020435363LF0000X
GARN329469363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003281846IMedicaid
FL11020435OtherFLORIDA STATE BOARD OF NURSING
NC5016835OtherNORTH CAROLINA STATE BOARD OF NURSING
GARN329469OtherGEORGIA BOARD OF NURSING