Healthcare Provider Details
I. General information
NPI: 1215316070
Provider Name (Legal Business Name): RANDI L YONTZ AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/27/2015
Last Update Date: 05/02/2024
Certification Date: 05/02/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1994 GALLATIN PIKE N STE 200
MADISON TN
37115-2024
US
IV. Provider business mailing address
1994 GALLATIN PIKE N STE 200
MADISON TN
37115-2024
US
V. Phone/Fax
- Phone: 615-851-9005
- Fax: 615-851-9007
- Phone: 615-851-9005
- Fax: 615-851-9007
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 237600000X |
| Taxonomy | Audiologist-Hearing Aid Fitter |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 231H00000X |
| Taxonomy | Audiologist |
| License Number | 0000001755 |
| License Number State | TN |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: