Provider Demographics
NPI:1952931792
Name:RATNER, LIBBY SLOSBURG (PA)
Entity type:Individual
Prefix:
First Name:LIBBY
Middle Name:SLOSBURG
Last Name:RATNER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:LIBBY
Other - Middle Name:SIMON
Other - Last Name:SLOSBURG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:14305 SOUTHCROSS DR W STE 110
Mailing Address - Street 2:
Mailing Address - City:BURNSVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55306-7011
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:14305 SOUTHCROSS DR W STE 110
Practice Address - Street 2:
Practice Address - City:BURNSVILLE
Practice Address - State:MN
Practice Address - Zip Code:55306-7011
Practice Address - Country:US
Practice Address - Phone:651-340-1064
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-21
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty