Individual
MARGIE RANDALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
210 MORRIS LN, HOMER, LA 71040-5985
(318) 225-2552
Mailing address
510 E STONER AVE, SHREVEPORT, LA 71101-4243
(318) 221-8411
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
240275
LA
Other
Enumeration date
04/20/2022
Last updated
04/20/2022
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