Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LF0000X | Nurse Practitioner - Family Medicine | 95009116 | CA |
Y | 363LP2300X | Nurse Practitioner - Primary Care | 95009116 | CA |
NPI | 1043798440 |
---|---|
Provider Name | Gina Ragsdale |
First Address | Raymond, CA 93653-9529 |
Second Address | Madera, CA 93636-8761 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/07/2018 |
Last Update Date | 26/04/2019 |