Individual
RANDALL MARK IPPOLITO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
100 BREWSTER BLVD, CAMP LEJEUNE, NC 28547-2575
(910) 450-4357
Mailing address
120 EMERALD VIEW DR, SWANSBORO, NC 28584-0219
(580) 301-1424
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
7882
NC
Other
Enumeration date
05/28/2025
Last updated
05/28/2025
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