Provider Demographics
NPI:1558853713
Name:RATLIFF, JARROD (MSNA, CRNA)
Entity Type:Individual
Prefix:
First Name:JARROD
Middle Name:
Last Name:RATLIFF
Suffix:
Gender:M
Credentials:MSNA, CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29170 S REDWOOD DR
Mailing Address - Street 2:
Mailing Address - City:DENHAM SPRINGS
Mailing Address - State:LA
Mailing Address - Zip Code:70726-3146
Mailing Address - Country:US
Mailing Address - Phone:985-381-9606
Mailing Address - Fax:
Practice Address - Street 1:29170 S REDWOOD DR
Practice Address - Street 2:
Practice Address - City:DENHAM SPRINGS
Practice Address - State:LA
Practice Address - Zip Code:70726-3146
Practice Address - Country:US
Practice Address - Phone:985-381-9606
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-04
Last Update Date:2020-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA215931367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered