Randel, Janice L
Randel, Janice L is an individual health care provider with primary practice located at 1500 Cooper St , Fort Worth TX 76104-2710. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Randel, Janice L can be contacted via phone (682) 885-2140.Contact Information
Primary practice address
1500 Cooper St
Fort Worth TX 76104-2710
Phone: (682) 885-2140
Fax: (817) 332-2506
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Pediatrics | 363LP0200X | 550916 | Texas |
Profile Details
| NPI number | 1023096963 |
|---|---|
| LBN Legal business name | Randel, Janice L |
| Credentials | Certified Pediatric Nurse Practitioner (CPNP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 30th, 2005 |
| Last updated | Apr 13th, 2012 - about 12 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1023096963 | NPPES |
| Texas | MEDICAID | 208265303 | |
| Texas | Other | 208265304 |
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