Individual
ADA PAULINE RANDALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
670 W FIREWEED LN STE 160, ANCHORAGE, AK 99503-2561
(907) 770-0862
Mailing address
648 WHITETAIL DR, FLEETWOOD, NC 28626-9280
(706) 331-3508
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
142293
AK
164X00000X
Licensed Vocational Nurse
253763
CA
Other
Enumeration date
06/16/2011
Last updated
02/21/2019
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