Individual
KATI LU RANDOLPH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
255 OCEAN LAKE RD, RIVERTON, WY 82501-8318
(307) 851-6387
(307) 332-0131
Mailing address
255 OCEAN LAKE RD, RIVERTON, WY 82501-0000
(307) 851-6387
(307) 332-0131
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
32141
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
32141
LICENSE
WY
Enumeration date
10/03/2013
Last updated
10/03/2013
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