Marie A Randall, LPN, MOBILE NOTARY

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

26NP06084800 Issued in NJ

Practice address

304 Weequahic Ave # 1
Newark, NJ 07112-1437

Phone

(973) 757-3757

NPI assigned

Feb 10, 2019

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1549756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549756800000",
    "number": "1881159275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 WEEQUAHIC AVE # 1",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071121437",
            "telephone_number": "973-757-3757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 WEEQUAHIC AVE # 1",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071121437",
            "telephone_number": "973-757-3757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDALL",
        "first_name": "MARIE",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "LPN, MOBILE NOTARY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-10",
        "last_updated": "2019-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Licensed Practical Nurse",
            "state": "NJ",
            "license": "26NP06084800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Licensed Practical Nurse in Newark, NJ
• Providers in Newark, NJ by specialty
• Licensed Practical Nurse in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.