Individual
JESSICA NICKOLE RANDOLPH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
400 TRACY WAY STE 100, CHARLESTON, WV 25311-1280
(304) 720-0205
(304) 720-0205
Mailing address
1070 NEW STONE RIDGE RD, RIPLEY, WV 25271-5264
(304) 549-6293
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
113070
WV
Other
Enumeration date
04/16/2025
Last updated
04/17/2025
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