Individual
CHRISTINA NICOLE RANDALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
111 DOCTORS DR, GREENVILLE, SC 29605-5622
(864) 797-7100
(864) 797-7105
Mailing address
1 INDEPENDENCE PT, SUITE 212, GREENVILLE, SC 29615-4545
(864) 797-6044
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
1365
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1150PA
—
SC
Enumeration date
11/17/2008
Last updated
06/06/2024
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