Bouchillon, Randi Nicole
Bouchillon, Randi Nicole is an individual health care provider with primary practice located at 12807 Old Fort Rd , Fort Washington MD 20744-2876. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Pediatrics, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Bouchillon, Randi Nicole can be contacted via phone (301) 292-7400.Contact Information
Primary practice address
12807 Old Fort Rd
Fort Washington MD 20744-2876
Phone: (301) 292-7400
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Nursing Service Providers / Pediatrics | 163WP0200X | R244896 | Maryland |
Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | R244896 | Maryland |
Profile Details
NPI number | 1437888138 |
---|---|
LBN Legal business name | Bouchillon, Randi Nicole |
Credentials | CRNP, FNP-C |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jun 8th, 2022 |
Last updated | Apr 12th, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1437888138 | NPPES |
Maryland | Other | R244896 | RN |
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