Individual
RANDI LYNNE MORELAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4315 MEMORIAL DR, BELLEVILLE, IL 62226-5342
(314) 996-7014
(314) 273-0140
Mailing address
PO BOX 959203, SAINT LOUIS, MO 63195-9203
(314) 996-7014
(314) 273-0140
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085006651
IL
363A00000X
Physician Assistant
2018038670
MO
363A00000X
Physician Assistant
PAT9110595
FL
Other
Enumeration date
08/31/2017
Last updated
12/01/2025
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