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General NPI Number Information
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NPI Number | 1104542109
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Entity Type | Individual
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Provider Name | RANDY PAUL GOLEMAN ARNP
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Gender | Male
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Dates
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Enumeration Date | 10/12/2022
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Last Update Date | 04/03/2023
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Provider Practice Location Address
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Address Line | 845 W KATHLEEN AVE
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City | COEUR D ALENE
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State | ID
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Zip | 83815-9405
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Country | US
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Telephone | 208-250-0428
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Fax |
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Provider Business Mailing Address
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Address Line | 6248 W AIRHORN AVE
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City | RATHDRUM
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State | ID
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Zip | 83858-8014
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Country | US
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Telephone | 208-250-0428
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | AP61409196
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | TEMP58976
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License Number State | ID
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 1112901
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | APRN-3981
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License Number State | HI
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Taxonomy #5
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 865047
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License Number State | NV
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Taxonomy #6
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 58976
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License Number State | ID
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