Provider Demographics
NPI:1033575402
Name:RANES, JESSICA SOLOMON (APRN)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:SOLOMON
Last Name:RANES
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 637273
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-7273
Mailing Address - Country:US
Mailing Address - Phone:812-842-4260
Mailing Address - Fax:812-602-3174
Practice Address - Street 1:4199 GATEWAY BLVD STE 3100
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:IN
Practice Address - Zip Code:47630-7906
Practice Address - Country:US
Practice Address - Phone:812-842-4550
Practice Address - Fax:812-842-4549
Is Sole Proprietor?:No
Enumeration Date:2016-01-14
Last Update Date:2020-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3010040363L00000X, 363LF0000X
IN71009732A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN71009732AOtherSTATE LICENSE