Provider Demographics
NPI:1801852389
Name:RAGSTER JOHNSON, LAZANYA LORENE (RN)
Entity Type:Individual
Prefix:
First Name:LAZANYA
Middle Name:LORENE
Last Name:RAGSTER JOHNSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6584 SUNNYFIELD WAY
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95823
Mailing Address - Country:US
Mailing Address - Phone:916-681-9432
Mailing Address - Fax:
Practice Address - Street 1:3415 MARTIN LUTHER KING BLVD
Practice Address - Street 2:
Practice Address - City:SACREMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817
Practice Address - Country:US
Practice Address - Phone:916-875-2932
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA593498163WM0705X, 163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical
Not Answered163WP0200XNursing Service ProvidersRegistered NursePediatrics