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Individual

RANDI BLISS KOTAL-LEE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
390 KEOWEE SCHOOL RD, SENECA, SC 29672-6743
(864) 885-7129
(864) 882-7240
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8603

Taxonomy

Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
18472
SC
363LG0600X
Gerontology Nurse Practitioner
RN218154
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
NP2705
SC
Enumeration date
03/21/2013
Last updated
02/10/2026
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