Provider Demographics
NPI:1861781171
Name:RANZ, JENNIFER TORRENCE (MD)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:TORRENCE
Last Name:RANZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 11TH ST NE
Mailing Address - Street 2:
Mailing Address - City:SPRINGHILL
Mailing Address - State:LA
Mailing Address - Zip Code:71075-4503
Mailing Address - Country:US
Mailing Address - Phone:318-539-1700
Mailing Address - Fax:318-539-5688
Practice Address - Street 1:2001 DOCTORS DR
Practice Address - Street 2:
Practice Address - City:SPRINGHILL
Practice Address - State:LA
Practice Address - Zip Code:71075-4526
Practice Address - Country:US
Practice Address - Phone:318-539-1000
Practice Address - Fax:318-539-4085
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-07
Last Update Date:2014-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA206600207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2144502Medicaid