| Tanisha Renee Ragland, RN | |
|
2830 S Kerckhoff Ave, San Pedro, CA 90731-6626 | |
| (585) 721-5686 | |
| Not Available |
| Full Name | Tanisha Renee Ragland |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner - Psychiatric/mental Health |
| Location | 2830 S Kerckhoff Ave, San Pedro, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154679462 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 163W00000X | Registered Nurse | 655565 (New York) | Secondary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | 95017916 (California) | Primary |
| Entity Name | Ehab Yacoub Md Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1417373713 PECOS PAC ID: 5092099523 Enrollment ID: O20170301002071 |
| Entity Name | Grow Healthcare Group Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1154994846 PECOS PAC ID: 1850774746 Enrollment ID: O20220809004080 |
| Mailing Address | Practice Location Address |
|---|---|
| Tanisha Renee Ragland, RN 2830 S Kerckhoff Ave, San Pedro, CA 90731-6626 Ph: (585) 721-5686 | Tanisha Renee Ragland, RN 2830 S Kerckhoff Ave, San Pedro, CA 90731-6626 Ph: (585) 721-5686 |
Jason Swiecki, FNP-BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1600 S Gaffey St, San Pedro, CA 90731 Phone: 510-847-6615 | |
Chinenye Deborah Udoh, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 711 W 39th St Apt 3, San Pedro, CA 90731 Phone: 310-999-5410 | |
Tara Lynn Shafer, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1350 W 6th St Ste 200, San Pedro, CA 90732 Phone: 310-832-0686 | |
Elizabeth Servaites, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1249 W 13th St, San Pedro, CA 90731 Phone: 310-418-6010 | |
Lilia Isabel Stephenson, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1921 W 26th St, San Pedro, CA 90732 Phone: 310-833-4661 | |
Jodi-anne Martina Davidson, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 528 W 23rd St, San Pedro, CA 90731 Phone: 713-859-8840 | |
Susan T Barie, NP, CNM Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 920 W 5th St, San Pedro, CA 90731 Phone: 310-833-6526 |