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Individual

JAMIE L. RANDALL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP, PMHNP

Contact information

Practice address
411 3RD ST, MONETT, MO 65708-2008
(417) 235-6610
(417) 354-0065
Mailing address
PO BOX 100, PIERCE CITY, MO 65723-2100
(417) 476-1000

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
2012011476
MO
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
2017001301
MO

Other

Enumeration date
04/26/2012
Last updated
10/19/2018
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