Type 1 individualNPI 1033663414
JESSICA RETTERATH CRNA, APRN
367500000X · LONG LAKE, MN
Why this profile is appearing now
Observed change signals
No current public change signal is attached to this profile.
Reported classification
Taxonomies
| Code | Description | Source flag |
|---|---|---|
| 367500000X | 367500000X | Primary |
| 163W00000X | 163W00000X | Additional |
| 163WC0200X | 163WC0200X | Additional |
Taxonomy reporting does not establish licensure, board certification, expertise, or quality.
Longitudinal record
Observed change timeline
- 0 recorded field change s