Mia Dawn Randle, FNP-C
Nurse Practitioner, Family in Columbus, MS. Individual provider (NPI-1).
NPI number1982109526
StatusActive
Last updated in NPPESNov 5, 2025
Details
- NPI
- 1982109526
- Entity type
- Individual (NPI-1)
- Name
- Ms. Mia Dawn Randle
- Credential
- FNP-C
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Mar 27, 2018
- Certification date
- Nov 5, 2025
- Last updated
- Nov 5, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | 907911 | MS | Yes |
Practice location
34 Glenwood DrColumbus, MS 39705-1596
Phone 662-307-7099
Mailing address
203 Jim Allen Blake RdCedarbluff, MS 39741-7048
Phone 662-307-7099
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