Doctor Name: | DAREN RANDALL |
NPI Number: | 1518222769 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | ARNP |
License Number: | A-131324 |
Business Practice Address: | 800 Oak St Sheldon, IA - 512011242 |
Business Phone Number: | 7123245356 |
Business Fax Number: | |
Mailing Address: | Po Box 5074, SIOUX FALLS |
State: | SD |
Postal Code: | 571175074 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 07/12/2012 |
NPI Last Update Date: | 10/01/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LA2100X |
License Number: | A-131324 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Acute Care |
Taxonomy Definition: |