Healthcare Provider Details

I. General information

NPI: 1295426724
Provider Name (Legal Business Name): SARAH RATLIFF
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2023
Last Update Date: 03/25/2024
Certification Date: 03/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 MEDICAL CENTER DR
HAZARD KY
41701-9421
US

IV. Provider business mailing address

465 ROY CAMPBELL DR
HAZARD KY
41701-9453
US

V. Phone/Fax

Practice location:
  • Phone: 606-439-6600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number4003232
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: