Provider Demographics
NPI:1043028632
Name:BURNEY, RATOSHA SHATEA (LPN)
Entity type:Individual
Prefix:MISS
First Name:RATOSHA
Middle Name:SHATEA
Last Name:BURNEY
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:804 WILLARD AVE SE
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44484-4432
Mailing Address - Country:US
Mailing Address - Phone:234-283-4344
Mailing Address - Fax:
Practice Address - Street 1:804 WILLARD AVE SE
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44484-4432
Practice Address - Country:US
Practice Address - Phone:234-283-4344
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-27
Last Update Date:2024-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH186478164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Single Specialty