Provider Demographics
NPI:1205067584
Name:FLETCHER, RANAE LASHELL (LPN)
Entity type:Individual
Prefix:MRS
First Name:RANAE
Middle Name:LASHELL
Last Name:FLETCHER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:509 S CORRELL ST
Mailing Address - Street 2:
Mailing Address - City:LANDIS
Mailing Address - State:NC
Mailing Address - Zip Code:28088-1832
Mailing Address - Country:US
Mailing Address - Phone:704-245-3307
Mailing Address - Fax:
Practice Address - Street 1:509 S CORRELL ST
Practice Address - Street 2:
Practice Address - City:LANDIS
Practice Address - State:NC
Practice Address - Zip Code:28088-1832
Practice Address - Country:US
Practice Address - Phone:704-245-3307
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-04
Last Update Date:2009-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC62203314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility