Individual
JENNA CATHERINE RANDALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, BSN, FNP-C
Contact information
Practice address
5000 CAMPUSWOOD DR, EAST SYRACUSE, NY 13057-1236
(315) 234-6677
Mailing address
239 MCKINLEY ST, MINOA, NY 13116-1717
(315) 380-9584
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
768513
NY
363L00000X
Nurse Practitioner
Primary
354439
NY
Other
Enumeration date
08/28/2024
Last updated
04/22/2025
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