Provider Demographics
NPI:1346124682
Name:RATTRAY, JAMELA (RN)
Entity type:Individual
Prefix:
First Name:JAMELA
Middle Name:
Last Name:RATTRAY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1717 BARRINGTON CT
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20721-2777
Mailing Address - Country:US
Mailing Address - Phone:443-351-8034
Mailing Address - Fax:
Practice Address - Street 1:440 MONTICELLO AVE
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23510-2571
Practice Address - Country:US
Practice Address - Phone:443-351-8034
Practice Address - Fax:443-351-8034
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-31
Last Update Date:2025-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY741285163W00000X
DCRN500326778163W00000X
MDR268203163W00000X
VA0001316461163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty