Provider Demographics
NPI:1518425586
Name:RANKIN, DOTTIE LYNN
Entity Type:Individual
Prefix:
First Name:DOTTIE
Middle Name:LYNN
Last Name:RANKIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1706 HARVEST MOON DR
Mailing Address - Street 2:
Mailing Address - City:GILLETTE
Mailing Address - State:WY
Mailing Address - Zip Code:82718-7879
Mailing Address - Country:US
Mailing Address - Phone:307-257-0479
Mailing Address - Fax:307-257-7526
Practice Address - Street 1:1706 HARVEST MOON DR
Practice Address - Street 2:
Practice Address - City:GILLETTE
Practice Address - State:WY
Practice Address - Zip Code:82718-7879
Practice Address - Country:US
Practice Address - Phone:307-257-0479
Practice Address - Fax:307-257-7526
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-07
Last Update Date:2019-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty