Bouchillon, Randi Nicole

Bouchillon, Randi Nicole is an individual health care provider with primary practice located at 12807 Old Fort Rd , Fort Washington MD 20744-2876. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Pediatrics, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Bouchillon, Randi Nicole can be contacted via phone (301) 292-7400.

Contact Information

Primary practice address
12807 Old Fort Rd Fort Washington MD 20744-2876
Phone: (301) 292-7400
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Pediatrics 163WP0200X R244896 Maryland
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X R244896 Maryland

Profile Details

NPI number 1437888138
LBN Legal business name Bouchillon, Randi Nicole
Credentials CRNP, FNP-C
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 8th, 2022
Last updated Apr 12th, 2023 - 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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Identifiers

StateTypeNumberIssuer
All States NPI 1437888138 NPPES
Maryland Other R244896 RN

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