Healthcare Provider Details

I. General information

NPI: 1760947030
Provider Name (Legal Business Name): RANDI SLONE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/31/2019
Last Update Date: 05/08/2025
Certification Date: 05/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 CARLTON DAVIDSON LN
COAL GROVE OH
45638-2924
US

IV. Provider business mailing address

901 WASHINGTON ST
PORTSMOUTH OH
45662-3944
US

V. Phone/Fax

Practice location:
  • Phone: 740-442-7637
  • Fax:
Mailing address:
  • Phone: 740-442-7637
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN.CNP.024146
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: