Provider Demographics
NPI:1679090948
Name:RATZLAFF, JASMINE DANIELLE (CARE COORDINATOR)
Entity type:Individual
Prefix:
First Name:JASMINE
Middle Name:DANIELLE
Last Name:RATZLAFF
Suffix:
Gender:F
Credentials:CARE COORDINATOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 W MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:BARNSDALL
Mailing Address - State:OK
Mailing Address - Zip Code:74002-0000
Mailing Address - Country:US
Mailing Address - Phone:918-847-3527
Mailing Address - Fax:918-777-9018
Practice Address - Street 1:401 W MAIN STREET
Practice Address - Street 2:
Practice Address - City:BARNSDALL
Practice Address - State:OK
Practice Address - Zip Code:74002-0000
Practice Address - Country:US
Practice Address - Phone:918-847-3527
Practice Address - Fax:918-777-9018
Is Sole Proprietor?:No
Enumeration Date:2017-08-27
Last Update Date:2018-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator