RANDELL JOHN HENDERSON (NPI# 1821495995) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821495995 |
| Entity Type | Individual |
| Full Name | RANDELL JOHN HENDERSON |
| Credential | RN |
| Practice Address |
1411 E College Dr Marshall MN 56258-2086 |
| Practice Telephone | 5075322264 |
| Enumeration Date | 2014-12-04 |
| Last Update Date | 2014-12-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163WC0400X |
Registered Nurse Specialization: Case Management |
R 168369-1 | MN | Nursing Service Providers |
| Street Address |
1411 E COLLEGE DR |
| City | MARSHALL |
| State | MN |
| Zip Code | 56258-2086 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053403006 | Kris Blaine Lastine | Chiropractor | 1411 E College Dr, Ste 4, Marshall, MN 56258 | 2006-09-28 |
| 1417337874 | Robert Paul Hennen | Chiropractor | 1411 E College Dr, Marshall, MN 56258-2086 | 2015-06-01 |
| 1780078840 | Danielle Regnier | Registered Nurse | 1411 E College Dr, Marshall, MN 56258-2086 | 2015-03-26 |
| 1699169938 | Alyssa Klukas | Registered Nurse | 1411 E College Dr, Marshall, MN 56258-2086 | 2015-03-25 |
| 1376959619 | Jennie Lyn Smith | Registered Nurse | 1411 E College Dr, Marshall, MN 56258-2086 | 2014-07-08 |
| 1205271756 | Jill Marie Jay | Registered Nurse | 1411 E College Dr, Marshall, MN 56258-2086 | 2013-05-09 |
| 1861732844 | Alyssa Chisholm | Registered Nurse | 1411 E College Dr, Marshall, MN 56258-2086 | 2013-02-27 |
| 1477837391 | Lastine Chiropractic PC | Chiropractor | 1411 E College Dr, Ste 4, Marshall, MN 56258-2086 | 2011-10-11 |
| 1902188550 | Sandra Jo Ellingboe | Licensed Practical Nurse | 1411 E College Dr, Marshall, MN 56258-2086 | 2011-09-09 |
| 1518263771 | Laura Rae Roxberg | Registered Nurse | 1411 E College Dr, Marshall, MN 56258-2086 | 2011-02-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285140012 | Action Manufacturing Inc | Durable Medical Equipment & Medical Supplies | 1105 Lake Road, Marshall, MN 56258 | 2017-12-15 |
| 1124579123 | Themarshrx | Durable Medical Equipment & Medical Supplies | 600 Sherman Ave, Marshall, MN 56258 | 2016-10-14 |
| 1780020370 | Heritage Pointe Senio | Assisted Living Facility | 207 N 4th Street, Marshall, MI 56258 | 2013-05-22 |
| 1528351178 | Lori Anne Lynner | Family Medicine | 3160 Us Hwy 59, Marshall, MN 56258 | 2011-05-16 |
| 1912148545 | Tami J Behnke | Counselor | 1418 State Street, Campus Religious Center, Marshall, MN 56258 | 2009-03-11 |
| 1073768396 | Sharyce Marie Audiology Inc | Audiologist | 1424 East College Drive, Suite 200, Marshall, MN 56258 | 2008-12-01 |
| 1497976625 | Erica Anne Jost | Specialist/Technologist | 1501 State Street, Marshall, MN 56258 | 2007-05-02 |
| 1265597470 | Nancy Louise Hemmingson | Optometrist | 300 S Bruce Street, Avera Marshall Southwest Ophthalmology, Marshall, MN 56258 | 2006-12-27 |
| 1407928187 | Midwest Vision Centers Inc | Technician/Technologist | 1113 E College Drive, Marshall, MN 56258 | 2006-11-15 |
| 1306918354 | Paul Joseph Puetz | Chiropractor | 111 Jewett St, Marshall, MN 56258 | 2006-11-14 |
| Find all providers in zip 56258 | ||||
| Taxonomy Code | 163WC0400X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Case Management |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093083438 | Nanette Lynn Hibler | Registered Nurse | 215 E Mansion St Ste 1f, Marshall, MI 49068-1167 | 2011-12-13 |
| 1770851461 | Joyce Elizabeth Irish | Registered Nurse | 215 E Mansion St Ste 1g, Marshall, MI 49068-1167 | 2011-12-08 |
| 1306119839 | Rene Byrd | Registered Nurse | 215 E Mansion St Ste 1g, Marshall, MI 49068-1167 | 2012-02-14 |
| 1790054351 | Charlotte R Closson | Registered Nurse | 215 E Mansion St Ste 1e, Marshall, MI 49068-1167 | 2011-12-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093312118 | Live Life Well Sevices LLC | Registered Nurse | 1469 Gardena Ave Ne, Fridley, MN 55432-5815 | 2020-10-01 |
| 1225641509 | Celia Marie Petrowiak | Registered Nurse | 308 Jeri St, Fairmont, MN 56031-3249 | 2020-08-26 |
| 1134762404 | Crystal Marie Macfarlane | Registered Nurse | 2232 Jefferson St, Duluth, MN 55812-2114 | 2019-10-19 |
| 1689237638 | Jill Wackler | Registered Nurse | 2404 Greenbriar Ln, Buffalo, MN 55313-2368 | 2019-04-16 |
| 1871082354 | Shelly Lynn Manthey | Registered Nurse | 2701 W Superior St Ste 101, Duluth, MN 55806-1857 | 2018-05-09 |
| 1184153579 | Emily Marie Domeier | Registered Nurse | 1961 Premier Dr., Suite 340, Mankato, MN 56001 | 2017-06-08 |
| 1366993339 | Kristen Mellen | Registered Nurse | 104 Buckingham Ct, Mankato, MN 56001-5576 | 2016-10-14 |
| 1821440165 | Lisa Moon | Registered Nurse | 13723 Findlay Ave, Apple Valley, MN 55124-8070 | 2016-07-11 |
| 1669857587 | Kacey Ann Kasel | Registered Nurse | 820 Winnebago Ave, Suite 3, Fairmont, MN 56031-3645 | 2015-07-21 |
| 1205218989 | Kristen Louise Siewert | Registered Nurse | 3249 Noble Ave N, Golden Valley, MN 55422-3016 | 2015-06-18 |
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| 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.