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NPI Code Detail

MEDICARE: JEANNA RANGBARAN ARNP

MEDICARE:   JEANNA  RANGBARAN  ARNP
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
1363LF0000XFamily Nurse PractitionerARNP9324013FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1699115436
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEANNA RANGBARAN ARNP
Provider Business Mailing Address
First Line : 851 NOTTAGE HILL ST
Second Line :
City : SAINT JOHNS
State : FL
Zip : 32259-8383
Country : US
Telephone Number : 904-312-4004
Fax Number :
Provider Business Practice Location Address
First Line : 4466 SWILCAN BRIDGE LN N
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32224-5617
Country : US
Telephone Number : 904-281-0944
Fax Number : 904-281-9806
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/25/2013
Last Update Date : 11/17/2016

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Directions to “ JEANNA RANGBARAN ARNP” Practice Location

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