Provider Demographics
NPI:1881300671
Name:FRATIANNI, JOHN R (DNAP, CRNA)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:R
Last Name:FRATIANNI
Suffix:
Gender:M
Credentials:DNAP, CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9479 N FORT WASHINGTON RD STE 103
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93730-5939
Mailing Address - Country:US
Mailing Address - Phone:559-494-4030
Mailing Address - Fax:559-494-4030
Practice Address - Street 1:9479 N FORT WASHINGTON RD STE 103
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93730-5939
Practice Address - Country:US
Practice Address - Phone:559-494-4030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-25
Last Update Date:2024-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95002309367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered