Provider Demographics
NPI:1750804209
Name:CLEARY, RANA JANINE (CMA, RMA, PN)
Entity type:Individual
Prefix:MRS
First Name:RANA
Middle Name:JANINE
Last Name:CLEARY
Suffix:
Gender:F
Credentials:CMA, RMA, PN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1944
Mailing Address - Street 2:
Mailing Address - City:OROFINO
Mailing Address - State:ID
Mailing Address - Zip Code:83544-1944
Mailing Address - Country:US
Mailing Address - Phone:208-310-9678
Mailing Address - Fax:
Practice Address - Street 1:301 CEDAR ST
Practice Address - Street 2:
Practice Address - City:OROFINO
Practice Address - State:ID
Practice Address - Zip Code:83544-9029
Practice Address - Country:US
Practice Address - Phone:208-476-5777
Practice Address - Fax:208-476-5385
Is Sole Proprietor?:No
Enumeration Date:2017-07-17
Last Update Date:2017-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID103252374700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374700000XNursing Service Related ProvidersTechnician