Individual provider · Type 1 NPI

Lisa Randolph

Family Nurse Practitioner · San Luis Obispo, CA

NPI number 1114393279 Active

Practice location

1010 Murray Ave
San Luis Obispo, CA 93405-1806

Mailing address

4562 Obispo Rd
Atascadero, CA 93422-1531

Specialties and licenses

TaxonomyCodeLicense
Family Nurse Practitioner Primary 363LF0000X95002336 (CA)

Family Nurse Practitioner: Definition to come...

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About NPI 1114393279

Lisa Randolph's National Provider Identifier is 1114393279, issued on Aug 12, 2015. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in San Luis Obispo, CA. The record was last updated on Aug 12, 2015.