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General NPI Number Information
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NPI Number | 1740503697
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Entity Type | Individual
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Provider Name | LEE JAMES RANALLI C.R.N.A.
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Gender | Male
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Dates
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Enumeration Date | 03/07/2010
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Last Update Date | 07/22/2015
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Provider Practice Location Address
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Address Line | 4838 E BASELINE RD #108
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City | MESA
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State | AZ
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Zip | 85206-4671
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Country | US
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Telephone | 480-220-4436
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Fax |
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Provider Business Mailing Address
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Address Line | 4838 E BASELINE RD #108
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City | MESA
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State | AZ
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Zip | 85206-4671
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Country | US
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Telephone | 480-220-4436
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | CRNA0708
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 146311
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License Number State | AZ
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