Provider Demographics
NPI:1740785914
Name:RANG, KELLY ANDREJKO (MD)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:ANDREJKO
Last Name:RANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KELLY
Other - Middle Name:MARIE
Other - Last Name:ANDREJKO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:T0913 CHILDREN'S HEALTH CENTER
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27710-0001
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:T0913 CHILDREN'S HEALTH CENTER
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27710-3039
Practice Address - Country:US
Practice Address - Phone:919-668-0477
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-28
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program