Individual
MRS. JENNIFER ANN RANDALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
7 MARSH BROOK DR STE 205, SOMERSWORTH, NH 03878-6523
(603) 742-2007
Mailing address
7 MARSH BROOK DR STE 205, SOMERSWORTH, NH 03878-6523
(603) 742-2007
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1463
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3117105
—
NH
Enumeration date
10/31/2018
Last updated
07/01/2019
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