Randy Provensal in Jackson - Nurse Anesthetist, Certified Registered
Randy Provensal - NPI 1356379325
Randy Provensal is a Nurse Anesthetist, Certified Registered in Jackson, Michigan. Randy Provensal practices all healthcare services and medical treatments related to Nurse Anesthetist, Certified Registered. The NPI Number for Randy Provensal is 1356379325. The last update date is 2023-09-06.
Randy Provensal's current location address is 744 W Michigan Ave, Jackson, Michigan. You can contact this provider via phone number 5177876440 and fax number 5177874146. The mailing address for Randy Provensal is 744 W Michigan Ave, Jackson, Michigan. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Randy Provensal |
|---|---|
| Address | 744 W Michigan Ave, Jackson, Michigan |
| Phone Number | 5177876440 |
| Fax Number | 5177874146 |
| Sole Proprietor | N |
| Credentials | CRNA |
NPI Number Detail
| NPI Number | 1356379325 |
|---|---|
| Provider Enumeration Date | 2006-06-29 |
| Last Updated Date | 2023-09-06 |
Provider Mailing Address Detail
| Address | 744 W Michigan Ave |
|---|---|
| City | Jackson |
| State | Michigan (MI) |
| Post Code | 492011909 |
| Phone Number | 5177876440 |
| Fax Number | 5177874146 |
Provider's Primary Taxonomy Detail
| Speciality | Nurse Anesthetist, Certified Registered |
|---|---|
| Taxonomy | 367500000X |
| Licence No | RN034091 |
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Definition: (1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and |
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Post Comment/ Review Below
What is the unique 10-digit identifier code issued to Randy Provensal by the Centers for Medicare & Medicaid Services?
The Randy Provensal has been assigned the NPI (National Provider Identifier) 1356379325 by the CMS (Centers for Medicare & Medicaid Services). This 10-digit code serves as a unique identification number for healthcare providers.
Could you provide the complete address where Randy Provensal is physically located?
The Randy Provensal is situated at the following address: 744 W Michigan Ave, Jackson, MI 492011909.
What is the Randy Provensal's area of specialization and corresponding taxonomy classification?
The Randy Provensal's specialty field is Nurse Anesthetist, Certified Registered, and it falls under the taxonomy code 367500000X, which categorizes healthcare providers based on their specialties.
On what date did the Centers for Medicare & Medicaid Services assign the 1356379325 to Randy Provensal?
The Centers for Medicare & Medicaid Services assigned the 1356379325 to Randy Provensal on 2006-06-29.
As of what date were the details pertaining to Randy Provensal last refreshed?
The information related to the Randy Provensal, including its address, specialty, and other relevant details, was last updated on 2023-09-06.
NPI Number: 1073517686
Address: 2100 Martin Luther King Jr Blvd, Clovis, NM