Individual
EARLIS RANDALL CHAMPAGNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
1528 US HIGHWAY 395 N, SUITE 100, GARDNERVILLE, NV 89410-5265
(775) 782-3671
(775) 782-6639
Mailing address
1665 OLD HOT SPRINGS RD, SUITE 157, CARSON CITY, NV 89706-0782
(775) 687-5162
(775) 687-5745
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
TRN 332256
NV
Other
Enumeration date
01/06/2012
Last updated
01/06/2012
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