Healthcare Provider Details

I. General information

NPI: 1023476488
Provider Name (Legal Business Name): MERIDITH RANCK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/01/2016
Last Update Date: 02/01/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

133 E FREDERICK ST
LANCASTER PA
17602-2222
US

IV. Provider business mailing address

18 INDIAN PATH LN
FEASTERVILLE TREVOSE PA
19053-6364
US

V. Phone/Fax

Practice location:
  • Phone: 717-394-9821
  • Fax: 717-394-0175
Mailing address:
  • Phone: 215-801-4529
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN587306
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: