| NPI | 1053500900 |
|---|---|
| Former Name | RANDA NELL GRACE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3005314) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: KY 1090068) |
| Enumeration Date | 2007-10-16 |
| Last Update Date | 2019-12-20 |