Randall Dermatology, Pc in West Lafayette Bra - Nurse Practitioner
Randall Dermatology, Pc - NPI 1245340488
Randall Dermatology, Pc is a Nurse Practitioner in West Lafayette Bra, Indiana. Randall Dermatology, Pc practices all healthcare services and medical treatments related to Nurse Practitioner. The NPI Number for Randall Dermatology, Pc is 1245340488. The last update date is 2020-08-22.
Randall Dermatology, Pc's current location address is 124 Sagamore Pkwy W, West Lafayette Bra, Indiana. You can contact this provider via phone number 7654636722 and fax number 7654630905. The mailing address for Randall Dermatology, Pc is 124 Sagamore Pkwy W, West Lafayette Bra, Indiana. To know further, please read the information below!
Provider Profile Detail
Provider Organization | Randall Dermatology, Pc |
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Address | 124 Sagamore Pkwy W, West Lafayette Bra, Indiana |
Phone Number | 7654636722 |
Fax Number | 7654630905 |
Sole Proprietor | -- |
Credentials | -- |
Authorized Official
Title or Position | PRESIDENT/ |
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Authorized Official Name | Randall K John |
Credentials | RPH,MD |
Telephone Number | 7654636722 |
NPI Number Detail
NPI Number | 1245340488 |
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Provider Enumeration Date | 2006-08-30 |
Last Updated Date | 2020-08-22 |
Provider Mailing Address Detail
Address | 124 Sagamore Pkwy W |
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City | West Lafayette Bra |
State | Indiana (IN) |
Post Code | 479061569 |
Phone Number | 7654636722 |
Fax Number | 7654630905 |
Provider's Primary Taxonomy Detail
Speciality | Nurse Practitioner |
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Taxonomy | 363L00000X |
Licence No | 71001017A |
Definition: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certifi |
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What is the unique 10-digit identifier code assigned to Randall Dermatology, Pc by the Centers for Medicare & Medicaid Services?
The Randall Dermatology, Pc has been issued the NPI (National Provider Identifier) 1245340488 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Could you please share the complete physical address where Randall Dermatology, Pc is geographically located?
The Randall Dermatology, Pc is physically situated at the following location: 124 Sagamore Pkwy W, West Lafayette Bra, IN, 479061569.
What is Randall Dermatology, Pc's specialized field of practice, and what is the corresponding taxonomy classification code?
The Randall Dermatology, Pc's area of specialization is Nurse Practitioner, and the corresponding taxonomy code that categorizes this field of practice is 363L00000X.
On what date did the Randall Dermatology, Pc receive the assignment of its 1245340488 from the Centers for Medicare & Medicaid Services?
The Randall Dermatology, Pc was issued its 1245340488 by the Centers for Medicare & Medicaid Services on 2006-08-30.
When was the information related to Randall Dermatology, Pc most recently updated or refreshed?
The details pertaining to the Randall Dermatology, Pc, including its address, specialty, and other relevant information, were last updated or refreshed on 2020-08-22.