Provider Demographics
NPI:1922610427
Name:RANKIN, JENAE ANNETTE (PT)
Entity Type:Individual
Prefix:
First Name:JENAE
Middle Name:ANNETTE
Last Name:RANKIN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1213 MASSMAN DR
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37217-1755
Mailing Address - Country:US
Mailing Address - Phone:651-239-0878
Mailing Address - Fax:
Practice Address - Street 1:INTELLIGENT THERAPY
Practice Address - Street 2:719 SOUTH MAIN STREET
Practice Address - City:SPRINGFIELD
Practice Address - State:TN
Practice Address - Zip Code:37172
Practice Address - Country:US
Practice Address - Phone:615-382-7979
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-18
Last Update Date:2020-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN12424225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist