Provider Demographics
NPI:1144928318
Name:RICHEY, MARY (MSN, APRN, PMHNP-BC)
Entity type:Individual
Prefix:MS
First Name:MARY
Middle Name:
Last Name:RICHEY
Suffix:
Gender:F
Credentials:MSN, APRN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9855 COUNTY ROAD 2331
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75707-6429
Mailing Address - Country:US
Mailing Address - Phone:903-570-1987
Mailing Address - Fax:941-584-9104
Practice Address - Street 1:9855 COUNTY ROAD 2331
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75707-6429
Practice Address - Country:US
Practice Address - Phone:903-570-1987
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-17
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1110940363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health