Randall, Glynnis D

Randall, Glynnis D is an individual health care provider with primary practice located at 975 Hall St , Wiggins MS 39577-2107. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Randall, Glynnis D can be contacted via phone (601) 528-9119.

Contact Information

Primary practice address
975 Hall St Wiggins MS 39577-2107
Phone: (601) 528-9119
Fax: (601) 528-9193
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X R764278 Mississippi

Profile Details

NPI number 1346355583
LBN Legal business name Randall, Glynnis D
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 20th, 2006
Last updated Nov 22nd, 2016 - about 10 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 1346355583 NPPES
Mississippi MEDICAID 0116288

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