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Mr. Randall Norman Procknow, RN
Home Health Registered Nurse in Omro, Wisconsin
NPI 1669653978

Randall Norman Procknow is a Home Health Registered Nurse based in Omro, WI and is specialized in Home Health. Randall Norman Procknow practices in Omro, WI and has the professional credentials of RN. The NPI Number for Randall Norman Procknow is 1669653978 and holds a License No. 58624 (Wisconsin).

The current practice location address for Randall Norman Procknow is 4352 Harbor Village Dr, Omro, WI and can be reached out via phone at 920-685-0898 and via fax at 920-685-2204.

Location: 4352 Harbor Village Dr, Omro, WI, 54963-9498
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1669653978
Provider Name
Randall Norman Procknow
Credential
RN
Provider Entity Type
Individual
Gender
Male
Address
4352 Harbor Village Dr, Omro, WI, 54963-9498
Phone Number
920-685-0898
Fax Number
920-685-2204
Provider Enumeration Date
11/15/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
38249600 05 WI
institution
Provider Business Practice Location Address Details
Address
4352 Harbor Village Dr
City
Omro
State
Wisconsin
Zip
54963-9498
Phone Number
920-685-0898
Fax Number
920-685-2204
person
Provider Business Mailing Address Details
Address
4352 Harbor Village Dr
City
Omro
State
Wisconsin
Zip
54963-9498
Phone Number
920-685-0898
Fax Number
920-685-2204
person
Provider's Taxonomy Details 1
Type
Nursing Service Providers
Classification
Registered Nurse
Speciality
Home Health
Taxonomy
163WH0200X
License No.
58624 (Wisconsin)
Definition
Definition to come...
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