KELSEY RANDALL


Address: 9003 E Shea Blvd # Az85260, Scottsdale, AZ 85260-6709
Phone: 9286078345

KELSEY RANDALL (NPI# 1699385419) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1699385419
Entity Type Individual
Full Name KELSEY RANDALL
Credential FNP-BC
Practice Address 9003 E Shea Blvd # Az85260
Scottsdale
AZ 85260-6709
Mailing Address 955 E Knox Rd Unit 230
Chandler
AZ 85225-1482
Practice Telephone 9286078345
Enumeration Date 2020-08-06
Last Update Date 2020-08-14
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 163WP0200X Registered Nurse
Specialization: Pediatrics
RN179953 AZ Nursing Service Providers
Y 363LF0000X Nurse Practitioner
Specialization: Family
243374 AZ Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
AZ CERTIFIED NURSE PRACTITIONER LICENSE NUMBER 243374 01
AZ NATIONAL COUNCIL OF STATE BOARDS OF NURSING 22467622 01

Office Location

Street Address 9003 E SHEA BLVD # AZ85260
City SCOTTSDALE
State AZ
Zip Code 85260-6709

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Taxonomy Information

Taxonomy Code 363LF0000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Family

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
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1609483486 Emma May Nurse Practitioner 26804 N 70th Pl, Scottsdale, AZ 85266-8824 2020-09-25
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1710592720 Kelly T Dowden Nurse Practitioner 7135 E Camelback Rd Ste 205, Scottsdale, AZ 85251-1290 2020-09-15
1770198020 Steve Joseph Csanyi Nurse Practitioner 812 N 87th St, Scottsdale, AZ 85257-4513 2020-09-14
1770196271 Amanda Marie Callahan Nurse Practitioner 3031 N Civic Center Plz Unit 219, Scottsdale, AZ 85251-7907 2020-08-25
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Competitor

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City SCOTTSDALE
Zip Code 85260

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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