Miskelly, Randle S

Miskelly, Randle S is an individual health care provider with primary practice located at 1306 Us Highway 45 N , Henderson TN 38340-4003. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as his primary health care specialty. Miskelly, Randle S can be contacted via phone (731) 989-9899.

Contact Information

Primary practice address
1306 Us Highway 45 N Henderson TN 38340-4003
Fax: (731) 989-3495
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 11859 Tennessee

Profile Details

NPI number 1013948066
LBN Legal business name Miskelly, Randle S
Credentials Advanced Practice Nurse (APN)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 6th, 2006
Last updated Feb 23rd, 2011 - about 15 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 1013948066 NPPES
Tennessee MEDICAID 3643080

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