Randolph, Jessica

Randolph, Jessica is an individual health care provider with primary practice located at 100 S Bliss Ave , Tahlequah OK 74464-2512. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Physician Assistants & Advanced Practice Nursing Providers / Medical. Physician Assistants & Advanced Practice Nursing Providers / Medical is her primary health care specialty. Randolph, Jessica can be contacted via phone (918) 458-3100.

Contact Information

Primary practice address
100 S Bliss Ave Tahlequah OK 74464-2512
Phone: (918) 458-3100
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 3205 Oklahoma

Profile Details

NPI number 1174842215
LBN Legal business name Randolph, Jessica
Credentials LPC, PA
Entity Individual
Sole proprietor 1 No
Enumeration date May 28th, 2010
Last updated Jul 22nd, 2021 - about 4 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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