Provider Demographics
NPI:1033256375
Name:EYERMAN, RANDI L (RN)
Entity Type:Individual
Prefix:
First Name:RANDI
Middle Name:L
Last Name:EYERMAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:RANDI
Other - Middle Name:L
Other - Last Name:CRANSTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:34 PILLARS LN
Mailing Address - Street 2:
Mailing Address - City:AVERILL PARK
Mailing Address - State:NY
Mailing Address - Zip Code:12018-3303
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:69 CHURCH ST
Practice Address - Street 2:
Practice Address - City:HOOSICK FALLS
Practice Address - State:NY
Practice Address - Zip Code:12090-1642
Practice Address - Country:US
Practice Address - Phone:518-686-0694
Practice Address - Fax:518-686-4862
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY444427-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health