Provider Demographics
NPI:1891193710
Name:RANDALL, KARIE (APRN)
Entity Type:Individual
Prefix:
First Name:KARIE
Middle Name:
Last Name:RANDALL
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:KARIE
Other - Middle Name:
Other - Last Name:BARNETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3325 RESEARCH WAY
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89706-7913
Mailing Address - Country:US
Mailing Address - Phone:775-888-6610
Mailing Address - Fax:775-888-4904
Practice Address - Street 1:3325 RESEARCH WAY
Practice Address - Street 2:
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89706-7913
Practice Address - Country:US
Practice Address - Phone:775-887-5140
Practice Address - Fax:775-884-3618
Is Sole Proprietor?:No
Enumeration Date:2014-12-09
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0991551363LF0000X
MI4704393449363LF0000X
NVAPRN002051363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1891193710Medicaid