Provider Demographics
NPI:1831602952
Name:RANKINS, NISHALA RENAY (RN)
Entity type:Individual
Prefix:MS
First Name:NISHALA
Middle Name:RENAY
Last Name:RANKINS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2713 BRICKRUN PL
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30909-2219
Mailing Address - Country:US
Mailing Address - Phone:770-940-7292
Mailing Address - Fax:
Practice Address - Street 1:2713 BRICKRUN PL
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30909-2219
Practice Address - Country:US
Practice Address - Phone:770-940-7292
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-11
Last Update Date:2017-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN234354163WH0200X, 163WH0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0500XNursing Service ProvidersRegistered NurseHemodialysis
No163WH0200XNursing Service ProvidersRegistered NurseHome Health