Individual
LAKEIDRIA RANDALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
7777 HENNESSY BLVD, STE. 301, BATON ROUGE, LA 70808-4300
(214) 592-2957
(225) 214-6437
Mailing address
7777 HENNESSY BLVD, STE. 301, BATON ROUGE, LA 70808-4300
(214) 592-2957
(225) 214-6437
Taxonomy
Speciality
Code
Description
License number
State
163WA2000X
Administrator Registered Nurse
112518
LA
367500000X
Certified Registered Nurse Anesthetist
Primary
AP07633
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2353403
—
LA
Enumeration date
02/08/2010
Last updated
09/22/2014
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