Provider Demographics
NPI:1467881052
Name:RAGER, JODI M (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:JODI
Middle Name:M
Last Name:RAGER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:188 INDUSTRIAL PARK RD
Mailing Address - Street 2:STE B
Mailing Address - City:EBENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15931-4107
Mailing Address - Country:US
Mailing Address - Phone:814-471-9005
Mailing Address - Fax:814-471-9007
Practice Address - Street 1:188 INDUSTRIAL PARK RD
Practice Address - Street 2:STE B
Practice Address - City:EBENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15931-4107
Practice Address - Country:US
Practice Address - Phone:814-471-9005
Practice Address - Fax:814-471-9007
Is Sole Proprietor?:No
Enumeration Date:2013-11-05
Last Update Date:2013-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP013126363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner