Provider Demographics
NPI:1043433287
Name:RANKIN, RANDAL ZANE (MS CCC SLP)
Entity Type:Individual
Prefix:
First Name:RANDAL
Middle Name:ZANE
Last Name:RANKIN
Suffix:
Gender:M
Credentials:MS CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 PARKCLIFF DR
Mailing Address - Street 2:
Mailing Address - City:HOLIDAY ISLAND
Mailing Address - State:AR
Mailing Address - Zip Code:72631-8045
Mailing Address - Country:US
Mailing Address - Phone:479-363-6422
Mailing Address - Fax:479-363-6763
Practice Address - Street 1:400 NATURAL RESOURCES DR
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-1501
Practice Address - Country:US
Practice Address - Phone:501-687-2000
Practice Address - Fax:501-687-1999
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARSP 2207235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR159988721Medicaid