Provider Demographics
NPI:1366132227
Name:RANCY, LANISHA
Entity type:Individual
Prefix:
First Name:LANISHA
Middle Name:
Last Name:RANCY
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 1:2018 MATT DR
Mailing Address - Street 2:
Mailing Address - City:COPPERAS COVE
Mailing Address - State:TX
Mailing Address - Zip Code:76522-7501
Mailing Address - Country:US
Mailing Address - Phone:254-350-4445
Mailing Address - Fax:
Practice Address - Street 1:2018 MATT DR
Practice Address - Street 2:
Practice Address - City:COPPERAS COVE
Practice Address - State:TX
Practice Address - Zip Code:76522-7501
Practice Address - Country:US
Practice Address - Phone:254-350-4445
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-12
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
372600000X, 376J00000X
TX36257329343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
No372600000XNursing Service Related ProvidersAdult Companion
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)