Healthcare Provider Details

I. General information

NPI: 1871599464
Provider Name (Legal Business Name): STACEY L RATIGAN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2005
Last Update Date: 12/08/2020
Certification Date: 12/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15237 CREATIVITY DR
CULPEPER VA
22701
US

IV. Provider business mailing address

PO BOX 21975
BELFAST ME
04915-4116
US

V. Phone/Fax

Practice location:
  • Phone: 540-321-4281
  • Fax: 540-321-4282
Mailing address:
  • Phone: 540-321-4281
  • Fax: 540-321-4282

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number0024164317
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024164317
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: