Provider Demographics
NPI:1093468423
Name:BOATMAN, FRATINA ROCHELLE (RN)
Entity Type:Individual
Prefix:MISS
First Name:FRATINA
Middle Name:ROCHELLE
Last Name:BOATMAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2186 ATKINS AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44107-5406
Mailing Address - Country:US
Mailing Address - Phone:216-860-6707
Mailing Address - Fax:
Practice Address - Street 1:2186 ATKINS AVE
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:OH
Practice Address - Zip Code:44107-5406
Practice Address - Country:US
Practice Address - Phone:216-860-6707
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-26
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA263214163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse