Individual
TANISHA RENEE RAGLAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
2830 S KERCKHOFF AVE, SAN PEDRO, CA 90731-6626
(585) 721-5686
Mailing address
2830 S KERCKHOFF AVE, SAN PEDRO, CA 90731-6626
(585) 721-5686
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
655565
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95017916
CA
Other
Enumeration date
08/16/2012
Last updated
02/13/2024
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