Provider Demographics
NPI:1972316974
Name:RAGLAND, CHARLOTTE CHEYENNE
Entity type:Individual
Prefix:DR
First Name:CHARLOTTE
Middle Name:CHEYENNE
Last Name:RAGLAND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4872 S MEAD PL
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85730-4606
Mailing Address - Country:US
Mailing Address - Phone:520-667-9163
Mailing Address - Fax:
Practice Address - Street 1:4872 S MEAD PL
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85730-4606
Practice Address - Country:US
Practice Address - Phone:520-235-1077
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-31
Last Update Date:2025-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program