Provider Demographics
NPI:1629216247
Name:RATTNER, ELIZABETH JOHNSON EGGERS (APRN, CNS)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:JOHNSON EGGERS
Last Name:RATTNER
Suffix:
Gender:F
Credentials:APRN, CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2001 BLOOMINGTON AVE S
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55404-3089
Mailing Address - Country:US
Mailing Address - Phone:612-301-3433
Mailing Address - Fax:612-638-0685
Practice Address - Street 1:2001 BLOOMINGTON AVE S
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55404-3089
Practice Address - Country:US
Practice Address - Phone:612-301-3433
Practice Address - Fax:612-638-0685
Is Sole Proprietor?:No
Enumeration Date:2009-02-04
Last Update Date:2018-04-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MNR1610596163WP0808X, 364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health