Provider Demographics
NPI:1912682188
Name:RATLIFF, LAURA (AGACNP-BC)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:RATLIFF
Suffix:
Gender:F
Credentials:AGACNP-BC
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:
Other - Last Name:GROSZKIEWICZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4334 DOVER CENTER RD
Mailing Address - Street 2:
Mailing Address - City:NORTH OLMSTED
Mailing Address - State:OH
Mailing Address - Zip Code:44070-2509
Mailing Address - Country:US
Mailing Address - Phone:814-392-2346
Mailing Address - Fax:
Practice Address - Street 1:9500 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44195-0001
Practice Address - Country:US
Practice Address - Phone:216-444-2200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-16
Last Update Date:2023-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0033967363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute CareGroup - Single Specialty