Provider Demographics
NPI:1376387290
Name:HAMBRICK, RANESIA L
Entity type:Individual
Prefix:
First Name:RANESIA
Middle Name:L
Last Name:HAMBRICK
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 1:7000 JULIAN AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63130-1938
Mailing Address - Country:US
Mailing Address - Phone:314-309-7122
Mailing Address - Fax:
Practice Address - Street 1:159 CROCKER PARK BLVD STE 400
Practice Address - Street 2:
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-8147
Practice Address - Country:US
Practice Address - Phone:513-513-6237
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-24
Last Update Date:2025-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator