MR. RANDALL NORMAN PROCKNOW R.N. NPI 1669653978

NPI Information

NPI: 1669653978
Provider Name: MR. RANDALL NORMAN PROCKNOW, R.N.
Classification: Registered Nurse - 163WH0200X
Entity Type: Individual

Specialization: Home Health

Address:
4352 HARBOR VILLAGE DR
OMRO, WI
ZIP 54963
Phone: (920) 685-0898
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MR. Randall Norman Procknow, R.N. is a home health registered nurse in Omro, WI. MR. Randall Norman Procknow, R.N. NPI is 1669653978. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

4352 HARBOR VILLAGE DR
OMRO, WI
ZIP 54963-498
Phone: (920) 685-0898
Fax: (920) 685-2204

The enumeration date for this NPI number is 11/15/2007 and was last updated on 11/15/2007.

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	163WH0200X	Registered Nurse	Home Health	58624	WISCONSIN	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	38249600	MEDICAID	WISCONSIN

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: 5/5/2024

NPI Synchronization or Removal

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