Individual
MRS. TAWANNA AMECCA RANDLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
REGISTERED NURSE
Contact information
Practice address
6208 LEHMAN DR, SUITE 201, COLORADO SPRINGS, CO 80918-8408
(719) 572-6100
Mailing address
7806 STOCKTON DR, FOUNTAIN, CO 80817-1434
(910) 818-0591
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
1624781
CO
Other
Enumeration date
02/16/2017
Last updated
02/16/2017
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