Randy Lee Province

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1033616719

Randy Lee Province is a Student in an Organized Health Care Education/Training Program in Floyd, Virginia. Licensed in Virginia. Registered with an NPI since 2018.

Licensed in: VA
In the registry since: 2018
Specialties on file: 2

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Practice location Address checks out

911 E Main St
Floyd, VA 24091-4183
Phone: (540) 745-0231
Fax: (540) 745-4028

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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary)	Taxonomy 207Q00000X · Licence 0102206605 (VA)
Student in an Organized Health Care Education/Training Program	Taxonomy 390200000X

Record details

NPI number	1033616719
Entity type	Individual (Type 1)
Gender	Female
Sole proprietor	No
NPI enumerated	April 10, 2018
Last updated in NPPES	April 15, 2022
Certification date	April 15, 2022
Mailing address	229 Morrison Ave, Pembroke, VA 24136-3003