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
Fax: (952) 401-8286
Website:

Health care specialties

SpecialtyCodeLicense #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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