Jacqueline Randa
Technician, Attendant Care Provider in Hales Corners, WI. Individual provider (NPI-1).
NPI number1013594894
StatusActive
Last updated in NPPESMar 26, 2021
Details
- NPI
- 1013594894
- Entity type
- Individual (NPI-1)
- Name
- Jacqueline Randa
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Mar 26, 2021
- Certification date
- Mar 26, 2021
- Last updated
- Mar 26, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 3747A0650X | Technician, Attendant Care Provider | – | – | Yes |
Practice location
5155 Brandons CtHales Corners, WI 53130
Phone 414-235-8310
Mailing address
8843 Knoll CtFranklin, WI 53132
Phone 262-994-8310
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