Provider Demographics
NPI:1194086249
Name:RATAJCZAK, JULIE ANN (STNA)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:ANN
Last Name:RATAJCZAK
Suffix:
Gender:F
Credentials:STNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13270 AUBURN RD
Mailing Address - Street 2:
Mailing Address - City:CHARDON
Mailing Address - State:OH
Mailing Address - Zip Code:44024-9344
Mailing Address - Country:US
Mailing Address - Phone:440-223-9306
Mailing Address - Fax:
Practice Address - Street 1:13270 AUBURN RD
Practice Address - Street 2:
Practice Address - City:CHARDON
Practice Address - State:OH
Practice Address - Zip Code:44024-9344
Practice Address - Country:US
Practice Address - Phone:440-223-9306
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-05
Last Update Date:2012-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH401309531011376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide