Provider Demographics
NPI:1568454619
Name:HOLIMAN-JAMES, RAGINA LYNN (APRN)
Entity Type:Individual
Prefix:MRS
First Name:RAGINA
Middle Name:LYNN
Last Name:HOLIMAN-JAMES
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3208 NW 63RD ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73116-3637
Mailing Address - Country:US
Mailing Address - Phone:405-849-4682
Mailing Address - Fax:405-849-4683
Practice Address - Street 1:3208 NW 63RD ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73116-3637
Practice Address - Country:US
Practice Address - Phone:405-849-4682
Practice Address - Fax:405-849-4683
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-16
Last Update Date:2021-06-07
Deactivation Date:2006-03-23
Deactivation Code:
Reactivation Date:2006-03-27
Provider Licenses
StateLicense IDTaxonomies
OKR0046683364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK731605248OtherTAX ID