Individual
FARELON ELISE RANDLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
500 RUSSELL ST STE 3, STARKVILLE, MS 39759-5411
(662) 324-2244
Mailing address
830 S GLOSTER ST, TUPELO, MS 38801-4996
(662) 377-3000
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
905602
MS
Other
Enumeration date
03/06/2021
Last updated
04/01/2024
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