Twenhafel, Randall

Twenhafel, Randall is an individual health care provider with primary practice located at 950 E Bogard Rd Ste 233 , Wasilla AK 99654-7185. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as his primary health care specialty. Twenhafel, Randall can be contacted via phone (907) 357-4543.

Contact Information

Primary practice address
950 E Bogard Rd Ste 233 Wasilla AK 99654-7185
Phone: (907) 357-4543
Fax: (907) 357-4533
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X 1145 Alaska

Profile Details

NPI number 1043208960
LBN Legal business name Twenhafel, Randall
Credentials Pediatric Nurse Practitioner (PNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 13th, 2005
Last updated Dec 14th, 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 1043208960 NPPES
Alaska MEDICAID NP0141

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