Individual
GREGORY H RANDLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1-043822
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
051557605
—
AL
01
—
510-03663
BC BS OF AL
AL
01
—
P00439520
RAILROAD MEDICARE
AL
Enumeration date
12/28/2005
Last updated
05/10/2017
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