NPI 1598658502

Johnnie Lynn Randolph

Practitioner Prosthetist Thibodaux, LA

Practice location

Address: 246 Shadow Pointe Rd, Thibodaux, LA 70301-8448
Phone: (985) 688-8264
Mailing address: 10202 Perkins Rowe STE E, Baton Rouge, LA 70810-2067

Registered specialties

Prosthetist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 224P00000X

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Registry record

NPI: 1598658502
Entity type: Individual
Sex (as registered): Female
NPI issued: 29 May 2025
Record last updated: 29 May 2025

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.