Provider Demographics
NPI:1851809529
Name:PYCARD, RANDA ALEASHA (MSN, FNP)
Entity Type:Individual
Prefix:MS
First Name:RANDA
Middle Name:ALEASHA
Last Name:PYCARD
Suffix:
Gender:F
Credentials:MSN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5481 STONE COVE DR SW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30331-8941
Mailing Address - Country:US
Mailing Address - Phone:206-383-6586
Mailing Address - Fax:
Practice Address - Street 1:5775 PEACHTREE DUNWOODY RD STE 425
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1556
Practice Address - Country:US
Practice Address - Phone:844-403-4325
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-16
Last Update Date:2022-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN209203363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
GARN209203OtherRN AND ARNP