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NPI Code Detail

MEDICARE: RANDI ELIZABETH LUPER MSN, APRN, FNP-C

MEDICARE: RANDI ELIZABETH LUPER MSN, APRN, FNP-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner2021023926MO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1790442143
Entity Type Code : Individual
Provider Name (Legal Business Name) : RANDI ELIZABETH LUPER MSN, APRN, FNP-C
Provider Business Mailing Address
First Line : 910 N COLLEGE AVE STE 4
Second Line :
City : COLUMBIA
State : MO
Zip : 65201-4797
Country : US
Telephone Number : 636-642-1215
Fax Number : 573-234-4799
Provider Business Practice Location Address
First Line : 910 N COLLEGE AVE STE 4
Second Line :
City : COLUMBIA
State : MO
Zip : 65201-4797
Country : US
Telephone Number : 636-642-1215
Fax Number : 573-234-4799
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/19/2021
Last Update Date : 12/17/2025

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