Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 176B00000X | Midwife | 001528 | NY |
NPI | 1013256734 |
---|---|
Provider Name | Ms. Jessica Ranallo |
First Address | Bloomington, MN 55425-4516 |
Second Address | Saint Paul, MN 55107-1805 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/02/2013 |
Last Update Date | 11/10/2021 |