Individual
MARY G RANDEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
600 HIGHLAND AVE, COMPLIANCE MAIL CODE 2433, MADISON, WI 53792-0001
(608) 662-0817
Mailing address
600 HIGHLAND AVE, COMPLIANCE MAIL CODE 2433, MADISON, WI 53792-0001
(608) 662-0817
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2446
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2446
NURSE PRACTITIONER
WI
01
—
74446
REGISTERED NURSE
WI
Enumeration date
12/19/2007
Last updated
03/07/2023
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