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General NPI Number Information
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NPI Number | 1962227074
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Entity Type | Individual
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Provider Name | GASNER RANCY NP
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Gender | Male
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Dates
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Enumeration Date | 11/22/2024
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Last Update Date | 12/16/2025
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Provider Practice Location Address
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Address Line | 905 SE 14TH AVE
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City | PORTLAND
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State | OR
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Zip | 97214-2569
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Country | US
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Telephone | 561-201-8454
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Fax | 971-339-4913
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Provider Business Mailing Address
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Address Line | 3401 TURTLE CV
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City | WEST PALM BEACH
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State | FL
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Zip | 33411-6473
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Country | US
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Telephone | 561-201-8454
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Fax | 971-339-4913
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 11036220
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License Number State | FL
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