Provider Demographics
NPI:1588747257
Name:TRATTLER, MARIA R (APRN, BC)
Entity type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:R
Last Name:TRATTLER
Suffix:
Gender:F
Credentials:APRN, BC
Other - Prefix:MRS
Other - First Name:MARIE
Other - Middle Name:R,
Other - Last Name:MCDONALD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN-BC
Mailing Address - Street 1:5670 PEACHTREE DUNWOODY RD.
Mailing Address - Street 2:SUITE 1000
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342
Mailing Address - Country:US
Mailing Address - Phone:404-255-1930
Mailing Address - Fax:404-459-8510
Practice Address - Street 1:5670 PEACHTREE DUNWOODY RD.
Practice Address - Street 2:SUITE 1000
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342
Practice Address - Country:US
Practice Address - Phone:404-255-1930
Practice Address - Fax:404-459-8510
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2012-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN150779363L00000X
GARN150779NP363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000953422CMedicaid
GA000953422CMedicaid
GA50BBKVXMedicare PIN