Provider Demographics
NPI:1427471051
Name:HENRY, RANDI JEAN (RN)
Entity type:Individual
Prefix:MS
First Name:RANDI
Middle Name:JEAN
Last Name:HENRY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:RANDI
Other - Middle Name:JEAN
Other - Last Name:STEVENS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN, RN
Mailing Address - Street 1:715 HORIZON DR
Mailing Address - Street 2:STE 225
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81506-8700
Mailing Address - Country:US
Mailing Address - Phone:970-683-7107
Mailing Address - Fax:970-683-7167
Practice Address - Street 1:6916 HIGHWAY 82
Practice Address - Street 2:
Practice Address - City:GLENWOOD SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:81601-9435
Practice Address - Country:US
Practice Address - Phone:970-945-2583
Practice Address - Fax:970-928-8852
Is Sole Proprietor?:No
Enumeration Date:2014-02-03
Last Update Date:2014-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO65202163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse