Randle, Tara Kay

Randle, Tara Kay is an individual health care provider with primary practice located at 54 Hospital Dr , Osage Beach MO 65065-3050. She recently has only one registered license in Dietary & Nutritional Service Providers / Dietitian, Registered, which is considered as her primary health care specialty. Randle, Tara Kay can be contacted via phone (573) 302-2736.

Contact Information

Primary practice address
54 Hospital Dr Osage Beach MO 65065-3050
Phone: (573) 302-2736
Fax: (573) 302-2755
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dietary & Nutritional Service Providers / Dietitian, Registered 133V00000X 2005032486 Missouri

Profile Details

NPI number 1528081288
LBN Legal business name Randle, Tara Kay
Credentials MSRDLDCDE
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 25th, 2006
Last updated Jun 9th, 2010 - about 15 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 1528081288 NPPES
Missouri Other 1528081288 NPI

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