Individual provider · Type 1 NPI
Mary Randolph, RN
Administrator Registered Nurse · Dove Creek, CO
NPI number
1396005443
Active
Practice location
497 West 4th Street
Dove Creek, CO 81324-0368
Fax (970) 677-2948
Mailing address
PO Box 368
Dove Creek, CO 81324-0368
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Administrator Registered Nurse Primary | 163WA2000X | 115016 (CO) |
Administrator Registered Nurse: Definition to come...
About NPI 1396005443
Mary Randolph, RN's National Provider Identifier is 1396005443, issued on May 23, 2012. The primary taxonomy on file is Administrator Registered Nurse (163WA2000X), and the practice location is in Dove Creek, CO. The record was last updated on May 23, 2012.