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General NPI Number Information
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NPI Number | 1790789030
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Entity Type | Individual
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Provider Name | STEVEN J. RATERMAN CRNA
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Gender | Male
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Dates
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Enumeration Date | 06/01/2005
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 211 SUDDERTH DR
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City | RUIDOSO
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State | NM
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Zip | 88345-6002
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Country | US
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Telephone | 505-257-7381
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Fax | 505-260-4338
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Provider Business Mailing Address
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Address Line | 1720 LOUISIANA BLVD NE STE 401
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City | ALBUQUERQUE
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State | NM
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Zip | 87110-7020
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Country | US
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Telephone | 505-260-4300
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Fax | 505-260-4338
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | R22133
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License Number State | NM
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