Doctor Name: | PATRICIA ANN RANDOLPH-CLARK |
NPI Number: | 1033275227 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RN, ANP |
License Number: | 301713 |
Business Practice Address: | 25 Woodruff St Saranac Lake, NY - 129831715 |
Business Phone Number: | 5188915484 |
Business Fax Number: | 5188915484 |
Mailing Address: | 25 Woodruff St, SARANAC LAKE |
State: | NY |
Postal Code: | 129831715 |
Phone Number: | 5188915484 |
Fax Number: | 5188915484 |
NPI Enumeration Date: | 12/29/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LA2200X |
License Number: | 301713 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Adult Health |
Taxonomy Definition: |