Healthcare Provider Details

I. General information

NPI: 1477556538
Provider Name (Legal Business Name): SHERI LYNNE RATLIFF ACNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 MEDICAL CENTER DR SUITE 2D
HAZARD KY
41701-9466
US

IV. Provider business mailing address

134 WOOTON ST
HAZARD KY
41701-1554
US

V. Phone/Fax

Practice location:
  • Phone: 606-487-7403
  • Fax: 606-487-7407
Mailing address:
  • Phone: 606-439-0966
  • Fax: 606-487-7407

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number3311P
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: