Individual
BEVERLY JAN RANDLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
F.N.P.
Contact information
Practice address
14724 HIGHWAY 15 N, LOUISVILLE, MS 39339-6318
(662) 773-7500
Mailing address
8613 MS HIGHWAY 12, ACKERMAN, MS 39735-8917
(662) 285-9460
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R652962
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000118926
—
MS
05
—
00118926
—
MS
Enumeration date
05/15/2006
Last updated
07/07/2025
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