Provider Demographics
NPI:1801666078
Name:RANKIN, ANGELA (IC/C0SA 991208)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:RANKIN
Suffix:
Gender:F
Credentials:IC/C0SA 991208
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:
Other - Last Name:HUDSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:IC/COSMO 91208
Mailing Address - Street 1:5591 WENDSBURY DR
Mailing Address - Street 2:
Mailing Address - City:TROTWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:45426-1115
Mailing Address - Country:US
Mailing Address - Phone:937-602-1522
Mailing Address - Fax:
Practice Address - Street 1:3000 SHILOH SPRINGS RD
Practice Address - Street 2:
Practice Address - City:TROTWOOD
Practice Address - State:OH
Practice Address - Zip Code:45426-2245
Practice Address - Country:US
Practice Address - Phone:937-529-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-08
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist
No225000000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotic Fitter