Individual
VICTORIA LANE RANDALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2503 BROADMOOR BLVD, MONROE, LA 71201-2987
(318) 388-6050
(318) 998-3017
Mailing address
PO BOX 4766, MONROE, LA 71211-4766
(318) 388-6050
(318) 998-3017
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
1182767
TX
363LG0600X
Gerontology Nurse Practitioner
Primary
226274
LA
363LG0600X
Gerontology Nurse Practitioner
230019
AR
363LG0600X
Gerontology Nurse Practitioner
3-001773
AL
363LG0600X
Gerontology Nurse Practitioner
316634
AZ
363LG0600X
Gerontology Nurse Practitioner
36424
TN
363LG0600X
Gerontology Nurse Practitioner
4021515
KY
363LG0600X
Gerontology Nurse Practitioner
79546
NM
363LG0600X
Gerontology Nurse Practitioner
878300
NV
363LG0600X
Gerontology Nurse Practitioner
C-APN.0103663-C-NP
CO
Other
Enumeration date
07/01/2022
Last updated
04/01/2025
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