Provider Demographics
NPI:1679780167
Name:RANGER, RENEE LYNN (RD)
Entity Type:Individual
Prefix:MS
First Name:RENEE
Middle Name:LYNN
Last Name:RANGER
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7712 NW 113TH PL
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73162-2541
Mailing Address - Country:US
Mailing Address - Phone:405-550-2790
Mailing Address - Fax:
Practice Address - Street 1:100 RED MOON CIRCLE
Practice Address - Street 2:
Practice Address - City:CONCHO
Practice Address - State:OK
Practice Address - Zip Code:73022
Practice Address - Country:US
Practice Address - Phone:405-422-7688
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1514133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered