Katie Randall
Individual provider Active NPI Licensed Practical Nurse · Fairfield, TX
NPI 1841816014 · NPPES record last updated Jun 23, 2020
Key facts
- NPI
- 1841816014
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Practical Nurse 164W00000X
- License
- 208619 (TX)
- Practice address
- 115 PR 1295
Fairfield, TX 75840 - Phone
- (903) 907-1637
- NPI assigned
- Jun 23, 2020
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 208619 | TX | MD | Licensed Practical Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 208619 | TX | Yes |
Addresses
Primary practice location
115 PR 1295
Fairfield, TX 75840
Mailing address
115 PR 1295
Fairfield, TX 75840
Phone (903) 907-1637
Other providers in Fairfield, TX
- John Daniel Morgan
- Moriah Munoz
- Matthew Noble
- Vance J Oglesbee
- Ignacio William Perez
- Cheryl F Roberts
- Jack D Runyan
- Lana Satterwhite
- Brenda Scott
- Merlin Leroy Shriner
All providers in Fairfield, TX · Licensed Practical Nurse in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 23, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.