Provider Demographics
NPI:1376942763
Name:RAJAN, RANI (PHARMD)
Entity Type:Individual
Prefix:
First Name:RANI
Middle Name:
Last Name:RAJAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:RANI
Other - Middle Name:
Other - Last Name:RAJU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:N2950 STATE ROAD 67
Mailing Address - Street 2:
Mailing Address - City:LAKE GENEVA
Mailing Address - State:WI
Mailing Address - Zip Code:53147-2655
Mailing Address - Country:US
Mailing Address - Phone:262-245-2319
Mailing Address - Fax:262-245-4995
Practice Address - Street 1:N2950 STATE ROAD 67
Practice Address - Street 2:
Practice Address - City:LAKE GENEVA
Practice Address - State:WI
Practice Address - Zip Code:53147-2655
Practice Address - Country:US
Practice Address - Phone:262-245-2319
Practice Address - Fax:262-245-4995
Is Sole Proprietor?:No
Enumeration Date:2014-08-21
Last Update Date:2022-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051302838183500000X
IA22347183500000X
WI17927-40183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist