Mary S Randall, NP

NPI #1174871420 in Boise, Idaho

Provider Information

NPI Number: 1174871420
Entity Type: Individual
Name: Mary S Randall, NP
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Nurse Practitioner
Credential: NP
Enumeration Date: Aug 16, 2012
Last Updated: Nov 30, 2016

Practice Location

Address: 6140 W CURTISIAN AVE
Address 2: STE 200
City: Boise
State: Idaho
ZIP Code: 83704-8880
Phone: (208) 302-0000

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Nurse Practitioner	363L00000X	Primary

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