Individual
DARA ANN RANDOLPH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
401 SOUTH QUEEN STREET, BERKELEY COUNTY BOARD OF EDUCATION, MARTINSBURG, WV 25401
(304) 267-3595
Mailing address
PO BOX 541, 841 DOMINION ROAD, GERRARDSTOWN, WV 25420
(304) 267-3595
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
62088
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810004180
—
WV
Enumeration date
04/08/2008
Last updated
12/22/2008
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