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General NPI Number Information
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NPI Number | 1396478830
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Entity Type | Individual
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Provider Name | VICTORIA LANE RANDALL NP
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Gender | Female
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Dates
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Enumeration Date | 07/01/2022
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Last Update Date | 04/01/2025
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Provider Practice Location Address
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Address Line | 2503 BROADMOOR BLVD
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City | MONROE
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State | LA
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Zip | 71201-2987
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Country | US
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Telephone | 318-388-6050
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Fax | 318-998-3017
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Provider Business Mailing Address
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Address Line | PO BOX 4766
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City | MONROE
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State | LA
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Zip | 71211-4766
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Country | US
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Telephone | 318-388-6050
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Fax | 318-998-3017
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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 | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 79546
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 36424
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 316634
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License Number State | AZ
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Taxonomy #4
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 4021515
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License Number State | KY
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Taxonomy #5
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 3-001773
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License Number State | AL
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Taxonomy #6
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 878300
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License Number State | NV
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Taxonomy #7
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 230019
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License Number State | AR
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Taxonomy #8
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 1182767
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License Number State | TX
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Taxonomy #9
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | C-APN.0103663-C-NP
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License Number State | CO
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Taxonomy #10
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 226274
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License Number State | LA
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