Provider Demographics
NPI:1033712005
Name:RATCLIFFE, JESSICA ALICIA
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:ALICIA
Last Name:RATCLIFFE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 1/2 MIDDLEBORO RD
Mailing Address - Street 2:
Mailing Address - City:EAST FREETOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02717-1711
Mailing Address - Country:US
Mailing Address - Phone:177-493-0716
Mailing Address - Fax:
Practice Address - Street 1:8 E WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:NORTH ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02760-2314
Practice Address - Country:US
Practice Address - Phone:508-695-1481
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-20
Last Update Date:2020-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH27472183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist