Provider Demographics
NPI:1831320548
Name:RANKIN, BONNIE LEANN
Entity Type:Individual
Prefix:
First Name:BONNIE
Middle Name:LEANN
Last Name:RANKIN
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 1:120 NORTHBROOK RD
Mailing Address - Street 2:
Mailing Address - City:NICHOLASVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40356-2915
Mailing Address - Country:US
Mailing Address - Phone:859-881-5786
Mailing Address - Fax:
Practice Address - Street 1:120 NORTHBROOK RD
Practice Address - Street 2:
Practice Address - City:NICHOLASVILLE
Practice Address - State:KY
Practice Address - Zip Code:40356-2915
Practice Address - Country:US
Practice Address - Phone:859-881-5786
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-29
Last Update Date:2010-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator