Individual provider · Type 1 NPI

Tara Randolph, PNP

Pediatric Nurse Practitioner · Minnetonka, MN

NPI number 1760119622 Active

Practice location

17705 Hutchins Dr
Minnetonka, MN 55345-4145

Fax (952) 401-8286

Mailing address

6100 W 101st St
Bloomington, MN 55438-1816

Specialties and licenses

TaxonomyCodeLicense
Pediatric Nurse Practitioner Primary 363LP0200X9228 (MN)

Pediatric Nurse Practitioner: Definition to come...

22 other providers at this address

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About NPI 1760119622

Tara Randolph, PNP's National Provider Identifier is 1760119622, issued on Aug 2, 2022. The primary taxonomy on file is Pediatric Nurse Practitioner (363LP0200X), and the practice location is in Minnetonka, MN. The record was last updated on Aug 2, 2022.