RANDY PROVENSAL

METAIRIE, LA
NPI1356379325
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy367500000X Nurse Anesthetist, Certified Registered
(Licence: LA  RN034091)
Enumeration Date2006-06-29
Last Update Date2023-09-06
Business Address
-- RANDY PROVENSAL CRNA
3510 N CAUSEWAY BLVD
METAIRIE, LA 70002-3531
Phone number: 504-779-5568
Mailing Address
-- RANDY PROVENSAL CRNA
744 W MICHIGAN AVE
JACKSON, MI 49201-1909
Phone number: 517-787-6440
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