NPI 1134630064

Randi Amanda Luthi, PAC

Practitioner Physician Assistant Jackson, WY

Practice location

Address: 555 E Broadway Ave STE 229, Jackson, WY 83001-8640
Phone: (307) 739-7665
Mailing address: PO Box 428, Jackson, WY 83001-0428

Registered specialties

Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363A00000X Licence PA731 (WY)

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Registry record

NPI: 1134630064
Entity type: Individual
Sex (as registered): Female
NPI issued: 18 Oct 2017
Record last updated: 10 Jun 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.