Individual provider · Type 1 NPI

Tyler William Randall

Family Nurse Practitioner · Canon City, CO

NPI number 1780241794 Active

Practice location

1338 Phay Ave
Canon City, CO 81212-2311

Mailing address

PO Box 911057
Denver, CO 80291-1057

Specialties and licenses

TaxonomyCodeLicense
Nurse Practitioner 363L00000XAP61177225 (WA)
Family Nurse Practitioner 363LF0000XAP61177225 (WA)
Family Nurse Practitioner Primary 363LF0000XAPN.0994692-NP (CO)

Family Nurse Practitioner: Definition to come...

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About NPI 1780241794

Tyler William Randall's National Provider Identifier is 1780241794, issued on May 24, 2019. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Canon City, CO. The record was last updated on Jun 19, 2024.