Provider Demographics
NPI:1386216992
Name:ROGERS, RANEKA LEE (APRN)
Entity Type:Individual
Prefix:
First Name:RANEKA
Middle Name:LEE
Last Name:ROGERS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:RANEKA
Other - Middle Name:
Other - Last Name:SULLIVAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:317 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BELLE CENTER
Mailing Address - State:OH
Mailing Address - Zip Code:43310-9753
Mailing Address - Country:US
Mailing Address - Phone:937-441-9329
Mailing Address - Fax:
Practice Address - Street 1:317 E MAIN ST
Practice Address - Street 2:
Practice Address - City:BELLE CENTER
Practice Address - State:OH
Practice Address - Zip Code:43310-9753
Practice Address - Country:US
Practice Address - Phone:937-441-9329
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-13
Last Update Date:2021-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0028901363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care