Provider Demographics
NPI:1548743784
Name:NITURA, RANAE (CA, RYT, PT)
Entity type:Individual
Prefix:
First Name:RANAE
Middle Name:
Last Name:NITURA
Suffix:
Gender:F
Credentials:CA, RYT, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28946 N 124TH GLN
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85383-0367
Mailing Address - Country:US
Mailing Address - Phone:623-693-0234
Mailing Address - Fax:
Practice Address - Street 1:7950 E REDFIELD RD STE 160
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-6935
Practice Address - Country:US
Practice Address - Phone:623-693-0234
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-13
Last Update Date:2018-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPH15CAT040632255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer