Healthcare Provider Details

I. General information

NPI: 1164401295
Provider Name (Legal Business Name): SHERI A TRATNACK NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/17/2006
Last Update Date: 11/06/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 7TH ST
GROTTOES VA
24441-1708
US

IV. Provider business mailing address

100 7TH ST PO BOX 489
GROTTOES VA
24441-1708
US

V. Phone/Fax

Practice location:
  • Phone: 540-249-5901
  • Fax: 540-249-5902
Mailing address:
  • Phone: 540-249-5901
  • Fax: 540-249-5902

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number0001072529
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number0024-072529
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: