Provider Demographics
NPI:1194137653
Name:ADAIR, AVRA RATLIFF (CRNP)
Entity type:Individual
Prefix:
First Name:AVRA
Middle Name:RATLIFF
Last Name:ADAIR
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 COUNTY ROAD 1217
Mailing Address - Street 2:
Mailing Address - City:VINEMONT
Mailing Address - State:AL
Mailing Address - Zip Code:35179-8698
Mailing Address - Country:US
Mailing Address - Phone:256-340-0012
Mailing Address - Fax:
Practice Address - Street 1:1216 SOMERVILLE RD SE
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35601-4335
Practice Address - Country:US
Practice Address - Phone:256-340-0012
Practice Address - Fax:254-340-1408
Is Sole Proprietor?:No
Enumeration Date:2014-06-02
Last Update Date:2014-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-118627363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care