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NPI Code Detail

MEDICARE: MICHELLE RANDALL PA-C

MEDICARE: MICHELLE RANDALL PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant50.008315RXOH

General Provider Information

NPI Number : 1629552302
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELLE RANDALL PA-C
Provider Business Mailing Address
First Line : 2170 ANDERSON FERRY RD
Second Line :
City : CINCINNATI
State : OH
Zip : 45238-3328
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2170 ANDERSON FERRY RD
Second Line :
City : CINCINNATI
State : OH
Zip : 45238-3328
Country : US
Telephone Number : 513-922-4271
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/19/2018
Last Update Date : 06/04/2024

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Directions to “ MICHELLE RANDALL PA-C” Practice Location

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