Provider Demographics
NPI:1134703655
Name:FLINN, RANEE CHARAN (MSOM, LAC)
Entity Type:Individual
Prefix:
First Name:RANEE
Middle Name:CHARAN
Last Name:FLINN
Suffix:
Gender:F
Credentials:MSOM, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15615 N ORACLE RD STE 135
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85739-9121
Mailing Address - Country:US
Mailing Address - Phone:530-945-4521
Mailing Address - Fax:
Practice Address - Street 1:15615 N ORACLE RD STE 115
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85739-9133
Practice Address - Country:US
Practice Address - Phone:530-945-4521
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-11
Last Update Date:2021-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1093171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist