Provider Demographics
NPI:1104652049
Name:COMPO, RANEE LOUISE (CNA)
Entity type:Individual
Prefix:
First Name:RANEE
Middle Name:LOUISE
Last Name:COMPO
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 N STALLMAN RD
Mailing Address - Street 2:
Mailing Address - City:PESHAWBESTOWN
Mailing Address - State:MI
Mailing Address - Zip Code:49682-9158
Mailing Address - Country:US
Mailing Address - Phone:231-534-7234
Mailing Address - Fax:
Practice Address - Street 1:2300 N STALLMAN RD
Practice Address - Street 2:
Practice Address - City:PESHAWBESTOWN
Practice Address - State:MI
Practice Address - Zip Code:49682-9158
Practice Address - Country:US
Practice Address - Phone:231-534-7234
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-09
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIMI000064982376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide