Healthcare Provider Details

I. General information

NPI: 1609781657
Provider Name (Legal Business Name): PAULA MICHELE RATLIFF
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/15/2026
Last Update Date: 08/15/2026
Certification Date: 08/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 TOWN HOLLOW RD
CEDAR BLUFF VA
24609-9622
US

IV. Provider business mailing address

503 ELK GARDEN RD
LEBANON VA
24266-6611
US

V. Phone/Fax

Practice location:
  • Phone: 276-963-3554
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number0001129775
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: