Tanteria Randolph, FNP-BC | |
3475 N Saratoga St, Oak Harbor, WA 98278-4927 | |
(360) 257-9633 | |
Not Available |
Full Name | Tanteria Randolph |
---|---|
Gender | Female |
Speciality | Nurse Practitioner |
Experience | 7 Years |
Location | 3475 N Saratoga St, Oak Harbor, Washington |
Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1326501883 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363LF0000X | Nurse Practitioner - Family | R242989 (Maryland) | Secondary |
363LF0000X | Nurse Practitioner - Family | SP019917 (Pennsylvania) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Holy Spirit Hospital | Camp hill, PA | Hospital |
St Joseph Medical Center | Reading, PA | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Penn State Health Community Medical Group Llc | 8729351077 | 657 |
Entity Name | Penn State Health Community Medical Group Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1861988644 PECOS PAC ID: 8729351077 Enrollment ID: O20170907002279 |
Mailing Address | Practice Location Address |
---|---|
Tanteria Randolph, FNP-BC 3475 N Saratoga St, Oak Harbor, WA 98278-4927 Ph: (360) 257-9633 | Tanteria Randolph, FNP-BC 3475 N Saratoga St, Oak Harbor, WA 98278-4927 Ph: (360) 257-9633 |
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