=====================================================
General NPI Number Information
=====================================================
NPI Number | 1245200500
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | BARBARA NAN RANDL-JAMES RN, NP, COHN-S
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/26/2006
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | PUEBLO CHEMICAL DEPOT OCCUPATIONAL HEALTH CLINIC 45825 HIGHWAY 96 EAST
-----------------------------------------------------
City | PUEBLO
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 81006-9330
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 719-549-4176
-----------------------------------------------------
Fax | 719-549-4406
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1418 30TH LN
-----------------------------------------------------
City | PUEBLO
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 81006-9551
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 719-549-4176
-----------------------------------------------------
Fax | 719-549-4406
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 163WX0106X
-----------------------------------------------------
Taxonomy Name | Occupational Health Registered Nurse
-----------------------------------------------------
License Number | 51651
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------