MRS. STEPHANIE TANYA RANDALL NP NPI 1104590025

NPI Information

NPI: 1104590025
Provider Name: MRS. STEPHANIE TANYA RANDALL, NP
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

Address:
2200 TYDD ST
EUREKA, CA
ZIP 95501
Phone: (707) 441-1624
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MRS. Stephanie Tanya Randall, NP is a family nurse practitioner in Eureka, CA. MRS. Stephanie Tanya Randall, NP NPI is 1104590025. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2200 TYDD ST
EUREKA, CA
ZIP 95501-284
Phone: (707) 441-1624

The enumeration date for this NPI number is 8/4/2021 and was last updated on 8/4/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	95017990	CALIFORNIA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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