Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mrs. Tahlia Mae Randall, PHYSICIANASSISTANT

Individual provider Physician Assistant · NPI 1790204055

Mrs. Tahlia Mae Randall, PHYSICIANASSISTANT is a Physician Assistant in Fayetteville, North Carolina. Works from 2 locations. Licensed in North Carolina.

Licensed in
NC
In the registry since
2017
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Practice location Address checks out

217 Glensford Dr
Fayetteville, NC 28314
Phone: (910) 483-4647
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1995 E Oakland Park Blvd Ste 250, Fort Lauderdale, FL 33306-1149 — (954) 791-6146

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 10-09313 (NC)

Record details

NPI number1790204055
Entity typeIndividual (Type 1)
GenderFemale
Credentials PHYSICIANASSISTANT
Sole proprietorNo
NPI enumeratedSeptember 18, 2017
Last updated in NPPESNovember 14, 2019

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