Provider Demographics
NPI:1073976775
Name:CODREAN, RANA (CST,CSFA)
Entity Type:Individual
Prefix:
First Name:RANA
Middle Name:
Last Name:CODREAN
Suffix:
Gender:F
Credentials:CST,CSFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20435 N 7TH ST
Mailing Address - Street 2:APT 1036
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85024-6024
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:20435 N 7TH ST
Practice Address - Street 2:APT 1036
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85024-6024
Practice Address - Country:US
Practice Address - Phone:714-943-9333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-30
Last Update Date:2016-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ161595246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant