Randolph, Tara
Randolph, Tara is an individual health care provider with primary practice located at 17705 Hutchins Dr , Minnetonka MN 55345-4145. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Randolph, Tara can be contacted via phone (952) 401-8252.Contact Information
Primary practice address
17705 Hutchins Dr
Minnetonka MN 55345-4145
Phone: (952) 401-8252
Fax: (952) 401-8286
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Pediatrics | 363LP0200X | 9228 | Minnesota |
Profile Details
| NPI number | 1760119622 |
|---|---|
| LBN Legal business name | Randolph, Tara |
| Credentials | Pediatric Nurse Practitioner (PNP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 2nd, 2022 |
| Last updated | Aug 2nd, 2022 - 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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