Provider Demographics
NPI:1285875443
Name:RAGSDALE, DANIEL HEATH (CRNA)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:HEATH
Last Name:RAGSDALE
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1027 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:37814-6632
Mailing Address - Country:US
Mailing Address - Phone:423-581-5987
Mailing Address - Fax:423-581-0984
Practice Address - Street 1:6130 E 81ST ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74137-2125
Practice Address - Country:US
Practice Address - Phone:918-401-1002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-18
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN14006367500000X
OKR0082952367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered