Kotal-Lee, Randi Bliss

Kotal-Lee, Randi Bliss is an individual health care provider with primary practice located at 390 Keowee School Rd , Seneca SC 29672-6743. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Gerontology, which is considered as her primary health care specialty. Kotal-Lee, Randi Bliss can be contacted via phone (864) 885-7129.

Contact Information

Primary practice address
390 Keowee School Rd Seneca SC 29672-6743
Phone: (864) 885-7129
Fax: (864) 882-7240
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Gerontology 363LG0600X RN218154 Georgia
Physician Assistants & Advanced Practice Nursing Providers / Gerontology 363LG0600X 18472 South Carolina

Profile Details

NPI number 1932441565
LBN Legal business name Kotal-Lee, Randi Bliss
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 21st, 2013
Last updated Jun 30th, 2021 - about 3 years 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1932441565 NPPES
South Carolina MEDICAID NP2705

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