Provider Demographics
NPI:1780305391
Name:RANCK, KELLYN ELIZABETH (ARNP-RN)
Entity type:Individual
Prefix:
First Name:KELLYN
Middle Name:ELIZABETH
Last Name:RANCK
Suffix:
Gender:F
Credentials:ARNP-RN
Other - Prefix:
Other - First Name:KELLYN
Other - Middle Name:ELIZABETH
Other - Last Name:KNABLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:15863 BURCH ISLAND CT
Mailing Address - Street 2:
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34787-9469
Mailing Address - Country:US
Mailing Address - Phone:717-994-2245
Mailing Address - Fax:
Practice Address - Street 1:5571 E SR 44
Practice Address - Street 2:
Practice Address - City:WILDWOOD
Practice Address - State:FL
Practice Address - Zip Code:34785-8282
Practice Address - Country:US
Practice Address - Phone:352-643-9080
Practice Address - Fax:352-571-6786
Is Sole Proprietor?:No
Enumeration Date:2022-09-12
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11010839363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health