Healthcare Provider Details

I. General information

NPI: 1245200500
Provider Name (Legal Business Name): BARBARA NAN RANDL-JAMES RN, NP, COHN-S
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 01/26/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PUEBLO CHEMICAL DEPOT OCCUPATIONAL HEALTH CLINIC 45825 HIGHWAY 96 EAST
PUEBLO CO
81006-9330
US

IV. Provider business mailing address

1418 30TH LN
PUEBLO CO
81006-9551
US

V. Phone/Fax

Practice location:
  • Phone: 719-549-4176
  • Fax: 719-549-4406
Mailing address:
  • Phone: 719-549-4176
  • Fax: 719-549-4406

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WX0106X
TaxonomyOccupational Health Registered Nurse
License Number51651
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: