Individual
MRS. RETHA JENNIFER RANDALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
26NN10600900
NJ
Other
Enumeration date
09/29/2008
Last updated
10/01/2008
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