Individual
SHAREL DIANNA RANDOLPH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, APRN, FNP-C
Contact information
Practice address
180 W ESPLANADE AVE, KENNER, LA 70065-2467
(504) 464-8600
Mailing address
2937 PENWOOD ST, GRETNA, LA 70056-7833
(504) 250-2379
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
F06191083
LA
Other
Enumeration date
11/06/2019
Last updated
09/14/2023
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