Provider Demographics
NPI:1902361538
Name:RANCK, JONATHAN MICHAEL (APRN NP-C)
Entity Type:Individual
Prefix:MR
First Name:JONATHAN
Middle Name:MICHAEL
Last Name:RANCK
Suffix:
Gender:M
Credentials:APRN NP-C
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:5110 S YALE AVE STE 525
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74135-7485
Mailing Address - Country:US
Mailing Address - Phone:918-392-4547
Mailing Address - Fax:
Practice Address - Street 1:5110 S YALE AVE STE 525
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-7485
Practice Address - Country:US
Practice Address - Phone:918-392-4547
Practice Address - Fax:918-392-4555
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-07
Last Update Date:2021-05-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK117808363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner