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Individual
TERESA N RANDOLPH
Active
Individual
TERESA N RANDOLPH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
45975
KS
363LF0000X
Family Nurse Practitioner
87036
OK
363LF0000X
Family Nurse Practitioner
Primary
A003603
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0087036
ARNP LICENSE
OK
05
—
200048950A
—
OK
Enumeration date
07/07/2006
Last updated
04/10/2023
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