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Individual

JULIE RANDOLPH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
2401 S 31ST ST, TEMPLE, TX 76508-3294
(254) 724-2111
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
502347
TX
367500000X
Certified Registered Nurse Anesthetist
Primary
AP118687
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
JULIEDR103
TX
Enumeration date
01/22/2010
Last updated
12/06/2023
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