Provider Demographics
NPI:1861957540
Name:RANDOL, JULLI ANN (APRN)
Entity type:Individual
Prefix:
First Name:JULLI
Middle Name:ANN
Last Name:RANDOL
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6101 WINDHAVEN PKWY STE 145
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-8198
Mailing Address - Country:US
Mailing Address - Phone:972-473-8980
Mailing Address - Fax:972-212-6851
Practice Address - Street 1:6101 WINDHAVEN PKWY STE 145
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-8198
Practice Address - Country:US
Practice Address - Phone:888-382-0161
Practice Address - Fax:888-750-8159
Is Sole Proprietor?:No
Enumeration Date:2019-02-06
Last Update Date:2021-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP140502363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily