Provider Demographics
NPI:1770985343
Name:RAU, RANDY JOSEPH (DNP, FNP-C)
Entity type:Individual
Prefix:MR
First Name:RANDY
Middle Name:JOSEPH
Last Name:RAU
Suffix:
Gender:M
Credentials:DNP, FNP-C
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:26 SW DEYO LANDING LOOP
Mailing Address - Street 2:
Mailing Address - City:CACHE
Mailing Address - State:OK
Mailing Address - Zip Code:73527-3278
Mailing Address - Country:US
Mailing Address - Phone:810-922-3592
Mailing Address - Fax:
Practice Address - Street 1:6876 W PHELPS RD
Practice Address - Street 2:
Practice Address - City:MANTON
Practice Address - State:MI
Practice Address - Zip Code:49663-9056
Practice Address - Country:US
Practice Address - Phone:147-968-0086
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-25
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4704410533363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily