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General NPI Number Information
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NPI Number | 1760884571
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Entity Type | Individual
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Provider Name | JAMIE RANDOLPH
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Gender | Female
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Dates
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Enumeration Date | 09/24/2014
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Last Update Date | 01/03/2025
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Provider Practice Location Address
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Address Line | 2206 VICTOR ST
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City | AURORA
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State | CO
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Zip | 80045-7400
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Country | US
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Telephone | 303-617-2300
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Fax | 303-617-2344
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Provider Business Mailing Address
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Address Line | 1290 CHAMBERS RD
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City | AURORA
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State | CO
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Zip | 80011-7117
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Country | US
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Telephone | 303-617-2300
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Fax | 303-617-2344
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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 | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | 1698017
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License Number State | CO
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