Healthcare Provider Details

I. General information

NPI: 1447573167
Provider Name (Legal Business Name): KASEY ERIN RANGAN RN MSN CPNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/09/2010
Last Update Date: 04/03/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4650 SUNSET BLVD MS 54
LOS ANGELES CA
90027
US

IV. Provider business mailing address

4650 SUNSET BLVD MS 54
LOS ANGELES CA
90027
US

V. Phone/Fax

Practice location:
  • Phone: 323-361-6053
  • Fax: 323-361-8767
Mailing address:
  • Phone: 323-361-6053
  • Fax: 323-361-8767

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number20090017
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: