Individual provider · Type 1 NPI
Jeremiah Scott Randall, PMHNP-BC
Psychiatric/Mental Health Nurse Practitioner · Mora, MN
NPI number
1407447246
Active
Practice location
841 Forest Ave E Ste 210
Mora, MN 55051-5501
Mailing address
PO Box 202
Ogilvie, MN 56358-0202
Other practice locations
- 6375 W 143rd St, Savage, MN 55378-2888 · (952) 592-2200
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | 8527 (MN) |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
Another provider at this address
Other psychiatric/mental health nurse practitioner providers in Mora
About NPI 1407447246
Jeremiah Scott Randall, PMHNP-BC's National Provider Identifier is 1407447246, issued on Feb 2, 2021. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Mora, MN. The record was last updated on Oct 30, 2024.