Provider Demographics
NPI:1598280596
Name:RAGLAND, JAMEELAH KENEE (CNP)
Entity Type:Individual
Prefix:
First Name:JAMEELAH
Middle Name:KENEE
Last Name:RAGLAND
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 BAILEY ST
Mailing Address - Street 2:APT 204
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90033-2460
Mailing Address - Country:US
Mailing Address - Phone:419-244-0445
Mailing Address - Fax:
Practice Address - Street 1:620 VIRGINIA ST
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43620-1113
Practice Address - Country:US
Practice Address - Phone:419-410-5819
Practice Address - Fax:419-410-5819
Is Sole Proprietor?:No
Enumeration Date:2017-08-10
Last Update Date:2020-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH021454363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily