Johnson Randall, Gwendolynn Delores
Johnson Randall, Gwendolynn Delores is an individual health care provider with primary practice located at 1000 36Th St , Vero Beach FL 32960-4862. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as her primary health care specialty. Johnson Randall, Gwendolynn Delores can be contacted via phone (772) 776-9621.Contact Information
Primary practice address
1000 36Th St
Vero Beach FL 32960-4862
Phone: (772) 776-9621
Fax: (772) 778-3494
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered | 367500000X | 17249 | Tennessee |
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered | 367500000X | APRN3034802 | Florida |
Profile Details
NPI number | 1184676975 |
---|---|
LBN Legal business name | Johnson Randall, Gwendolynn Delores |
Credentials | CRNA, PHD,APRN |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | May 17th, 2006 |
Last updated | May 15th, 2024 - about 4 months ago |
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 | 1184676975 | NPPES |
Florida | Other | G3421 | BCBS |
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