Provider Demographics
NPI:1871471334
Name:RANSBOTTOM, MARLA RENEE
Entity type:Individual
Prefix:
First Name:MARLA
Middle Name:RENEE
Last Name:RANSBOTTOM
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 1:48 TOWNSHIP ROAD 194 E
Mailing Address - Street 2:
Mailing Address - City:PROCTORVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45669-8571
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:48 TOWNSHIP ROAD 194 E
Practice Address - Street 2:
Practice Address - City:PROCTORVILLE
Practice Address - State:OH
Practice Address - Zip Code:45669-8571
Practice Address - Country:US
Practice Address - Phone:740-794-1780
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-23
Last Update Date:2025-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN079320164W00000X
3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant