Provider Demographics
NPI:1306952973
Name:RANEY, JANE (CNP)
Entity type:Individual
Prefix:
First Name:JANE
Middle Name:
Last Name:RANEY
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2420 W PIERCE ST
Mailing Address - Street 2:STE 200B
Mailing Address - City:CARLSBAD
Mailing Address - State:NM
Mailing Address - Zip Code:88220-3543
Mailing Address - Country:US
Mailing Address - Phone:575-628-0926
Mailing Address - Fax:575-628-0493
Practice Address - Street 1:2420 W PIERCE ST
Practice Address - Street 2:STE 205
Practice Address - City:CARLSBAD
Practice Address - State:NM
Practice Address - Zip Code:88220-3543
Practice Address - Country:US
Practice Address - Phone:505-887-0530
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2008-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMR21628363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM74375881Medicaid
NM00NM006463OtherBCBS