Provider Demographics
NPI:1093861114
Name:EPSTEIN, RANDY LYNN (CRNP)
Entity Type:Individual
Prefix:MS
First Name:RANDY
Middle Name:LYNN
Last Name:EPSTEIN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 HUGO CT
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20906-5915
Mailing Address - Country:US
Mailing Address - Phone:301-962-7370
Mailing Address - Fax:
Practice Address - Street 1:2000 DENNIS AVE
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20902-4136
Practice Address - Country:US
Practice Address - Phone:240-777-1738
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR077703363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD24001100Medicaid