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Randy Wayne Lasut Jr., CRNP FNP-C

Nurse Practitioner, Family in New Paris, PA. Individual provider (NPI-1).

NPI number1063282994
StatusActive
Last updated in NPPESJul 30, 2024

Details

NPI
1063282994
Entity type
Individual (NPI-1)
Name
Mr. Randy Wayne Lasut Jr.
Credential
CRNP FNP-C
Sex
Male
Sole proprietor
No
Enumeration date
Jan 2, 2024
Certification date
Jul 30, 2024
Last updated
Jul 30, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LF0000X Nurse Practitioner, FamilySP029010PAYes

Practice location

4186 Cortland Dr
New Paris, PA 15554-7706

Phone 814-839-4108

Mailing address

4186 Cortland Dr
New Paris, PA 15554-7706

Phone 814-839-4108

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