Individual
JANICE L RANDEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
1500 COOPER ST, FORT WORTH, TX 76104-2710
(682) 885-2140
(817) 332-2506
Mailing address
PO BOX 99371, FORT WORTH, TX 76199-0371
(682) 885-1855
(682) 885-7347
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
550916
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
208265303
—
TX
01
—
208265304
CSHCN
TX
Enumeration date
12/30/2005
Last updated
04/13/2012
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