Individual
MR. RANDALL GENE RICHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1415 TULANE AVE, NEW ORLEANS, LA 70112-2600
(504) 779-5568
Mailing address
3510 N CAUSEWAY BLVD, SUITE 404, METAIRIE, LA 70002-3531
(504) 779-5515
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN049958
LA
367500000X
Certified Registered Nurse Anesthetist
Primary
RN049958 AP02486
LA
Other
Enumeration date
03/19/2007
Last updated
07/09/2010
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