Provider Demographics
NPI:1700408507
Name:RANES, TIFFINY MARIE
Entity Type:Individual
Prefix:
First Name:TIFFINY
Middle Name:MARIE
Last Name:RANES
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 1:240 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:GOOD HOPE
Mailing Address - State:IL
Mailing Address - Zip Code:61438-9161
Mailing Address - Country:US
Mailing Address - Phone:505-328-6972
Mailing Address - Fax:
Practice Address - Street 1:240 E MAIN ST
Practice Address - Street 2:
Practice Address - City:GOOD HOPE
Practice Address - State:IL
Practice Address - Zip Code:61438-9161
Practice Address - Country:US
Practice Address - Phone:505-328-6972
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-14
Last Update Date:2020-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health