Individual
RANDALL TWENHAFEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PNP
Contact information
Practice address
950 E BOGARD RD STE 233, WASILLA, AK 99654-7185
(907) 357-4543
(907) 357-4533
Mailing address
950 E BOGARD RD STE 233, WASILLA, AK 99654-7185
(907) 357-4543
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
1145
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP0141
—
AK
Enumeration date
10/13/2005
Last updated
12/14/2011
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