Provider Demographics
NPI:1619335957
Name:DOZIER YORK, RANADA
Entity type:Individual
Prefix:
First Name:RANADA
Middle Name:
Last Name:DOZIER YORK
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 1:8402 ROSWELL RD
Mailing Address - Street 2:APT C
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30350-7826
Mailing Address - Country:US
Mailing Address - Phone:843-372-0745
Mailing Address - Fax:
Practice Address - Street 1:1382 FULTON AVE
Practice Address - Street 2:
Practice Address - City:KINGSTREE
Practice Address - State:SC
Practice Address - Zip Code:29556-2218
Practice Address - Country:US
Practice Address - Phone:843-372-0745
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-01
Last Update Date:2016-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health