Green, Randi Nicole

Green, Randi Nicole is an individual health care provider with primary practice located at 79 Roosevelt Ave , Benwood WV 26031-1014. She recently has only one registered license in Nursing Service Related Providers / Personal Care Attendant, which is considered as her primary health care specialty. Green, Randi Nicole can be contacted via phone (304) 650-3267.

Contact Information

Primary practice address
79 Roosevelt Ave Benwood WV 26031-1014
Phone: (304) 650-3267
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Related Providers / Personal Care Attendant 3747P1801X

Profile Details

NPI number 1295502177
LBN Legal business name Green, Randi Nicole
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 11th, 2023
Last updated Dec 11th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1295502177 NPPES
West Virginia MEDICAID 18212062228
West Virginia MEDICAID 125553494
West Virginia MEDICAID 1356607394

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