MEDICARE: RANNY KEOPRADABSY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	95327547	CA

General Provider Information

NPI Number	:	1982571246
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RANNY KEOPRADABSY

Provider Business Mailing Address
First Line	:	12076 PEACHDALE CT
Second Line	:
City	:	RANCHO CORDOVA
State	:	CA
Zip	:	95742-8188
Country	:	US
Telephone Number	:	209-298-7276
Fax Number	:

Provider Business Practice Location Address
First Line	:	12076 PEACHDALE CT
Second Line	:
City	:	RANCHO CORDOVA
State	:	CA
Zip	:	95742-8188
Country	:	US
Telephone Number	:	209-298-7276
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/21/2025
Last Update Date	:	10/21/2025

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