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Individual

MICHELE RANDOLPH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
AGACNP

Contact information

Practice address
661 UNIVERSITY LN STE B, ORANGE, VA 22960-2243
(540) 661-3004
Mailing address
PO BOX 749112, ATLANTA, GA 30374-9112
(434) 295-1000

Taxonomy

Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
Primary
0001222321
VA
207RN0300X
Nephrology Physician
0024194769
VA
363LA2100X
Acute Care Nurse Practitioner
Primary
0024194769
VA

Other

Enumeration date
02/01/2025
Last updated
01/12/2026
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