Provider Demographics
NPI:1679285464
Name:RATERMAN, BRIANA MARIE (FNP-C)
Entity Type:Individual
Prefix:
First Name:BRIANA
Middle Name:MARIE
Last Name:RATERMAN
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1051 MITCHELL WAY
Mailing Address - Street 2:
Mailing Address - City:PACIFIC
Mailing Address - State:MO
Mailing Address - Zip Code:63069-6318
Mailing Address - Country:US
Mailing Address - Phone:636-297-0057
Mailing Address - Fax:
Practice Address - Street 1:500 CHESTERFIELD CTR STE 250
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-4833
Practice Address - Country:US
Practice Address - Phone:636-519-8889
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-23
Last Update Date:2022-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2022049212363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner