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Individual

RANDAL HERBERT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
FNP-C

Contact information

Practice address
14116 CUSTOMS BLVD, GULFPORT, MS 39503-5164
(601) 957-6300
Mailing address
4200 IOLA ST., METAIRIE, LA 70001
(504) 296-0777
(504) 455-2992

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F0613731
LA

Other

Enumeration date
06/28/2013
Last updated
10/25/2019
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