Individual
RANDI MCKISSICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5425 AUSTRALIAN AVE, LAS VEGAS, NV 89142-2702
(801) 824-3611
Mailing address
5425 AUSTRALIAN AVE, LAS VEGAS, NV 89142-2702
(801) 824-3611
Taxonomy
Speciality
Code
Description
License number
State
246QB0000X
Blood Banking Specialist/Technologist
3137
UT
246QB0000X
Blood Banking Specialist/Technologist
Primary
45151-TS-0
NV
Other
Enumeration date
08/16/2016
Last updated
08/16/2016
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