Individual
MR. RANDY BARGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
1451 DOWELL SPRINGS BLVD, KNOXVILLE, TN 37909-2441
(865) 970-9800
Mailing address
1451 DOWELL SPRINGS BLVD, KNOXVILLE, TN 37909-2441
(865) 970-9800
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
28859
TN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
71010173A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q066255
—
TN
Enumeration date
07/27/2020
Last updated
07/02/2021
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