Healthcare Provider Details

I. General information

NPI: 1891193710
Provider Name (Legal Business Name): KARIE RANDALL APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KARIE BARNETT

II. Dates (important events)

Enumeration Date: 12/09/2014
Last Update Date: 01/08/2024
Certification Date: 01/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3325 RESEARCH WAY
CARSON CITY NV
89706-7913
US

IV. Provider business mailing address

3325 RESEARCH WAY
CARSON CITY NV
89706-7913
US

V. Phone/Fax

Practice location:
  • Phone: 775-887-5140
  • Fax: 775-884-3618
Mailing address:
  • Phone: 775-888-6610
  • Fax: 775-888-4904

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN002051
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0991551
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4704393449
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: