Healthcare Provider Details

I. General information

NPI: 1689014201
Provider Name (Legal Business Name): VERONICA RATLIFF RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2013
Last Update Date: 06/27/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

VILSECK TROOP MEDICAL CLINIC CMR 411, BLDG 701, ROSE BARRACKS
APO AE
09112
US

IV. Provider business mailing address

CMR 411 BOX 3945
APO AE
09112-0040
US

V. Phone/Fax

Practice location:
  • Phone: 499662834719
  • Fax: 499662834719
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number740601
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: