DR. JACQUETTA TAISHA RANDALL M.D. NPI 1588982466

NPI Information

NPI: 1588982466
Provider Name: DR. JACQUETTA TAISHA RANDALL, M.D.
Classification: Pediatrics - 208000000X
Entity Type: Individual
Address:
451 RUIN CREEK RD
SUITE 101
HENDERSON, NC
ZIP 27536
Phone: (252) 492-9565
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DR. Jacquetta Taisha Randall, M.D. is a pediatrics in Henderson, NC. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. DR. Jacquetta Taisha Randall, M.D. NPI is 1588982466. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

451 RUIN CREEK RD
SUITE 101
HENDERSON, NC
ZIP 27536-878
Phone: (252) 492-9565

The enumeration date for this NPI number is 5/17/2010 and was last updated on 10/29/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	208000000X	Pediatrics		A111970	CALIFORNIA	No
2	208000000X	Pediatrics		2012-01956	NORTH CAROLINA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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