Provider Demographics
NPI:1871144097
Name:RAGLAND, PRISCILLA R
Entity type:Individual
Prefix:
First Name:PRISCILLA
Middle Name:R
Last Name:RAGLAND
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 1:10722 BENT TREE DR
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22407-1625
Mailing Address - Country:US
Mailing Address - Phone:540-604-6055
Mailing Address - Fax:
Practice Address - Street 1:12100 MEADOW BRANCH WAY
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22407-2573
Practice Address - Country:US
Practice Address - Phone:540-735-7800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-28
Last Update Date:2019-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider