Basic Information
Provider Information
NPI: 1184208993
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RANSON
FirstName: RACHEL
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: DO
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: SORRELLS
OtherFirstName: RACHEL
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 2150 PENNSYLVANIA AVE NW
Address2:  
City: WASHINGTON
State: DC
PostalCode: 200373201
CountryCode: US
TelephoneNumber: 2027413000
FaxNumber:  
Practice Location
Address1: 900 23RD ST NW
Address2:  
City: WASHINGTON
State: DC
PostalCode: 200372342
CountryCode: US
TelephoneNumber: 2027154000
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/07/2021
LastUpdateDate: 05/07/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 04/21/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X  Y Student, Health CareStudent in an Organized Health Care Education/Training Program 

No ID Information.


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