Provider Demographics
NPI:1750802252
Name:MCMANAMON, RANAE (RN BSN CCRN)
Entity type:Individual
Prefix:MRS
First Name:RANAE
Middle Name:
Last Name:MCMANAMON
Suffix:
Gender:F
Credentials:RN BSN CCRN
Other - Prefix:
Other - First Name:RANAE
Other - Middle Name:
Other - Last Name:BOBBIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:329 FOREST MEADOWS DR
Mailing Address - Street 2:
Mailing Address - City:MEDINA
Mailing Address - State:OH
Mailing Address - Zip Code:44256-1611
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:329 FOREST MEADOWS DR
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256-1611
Practice Address - Country:US
Practice Address - Phone:330-304-6456
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-05
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH220184163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse