Provider Demographics
NPI:1437832904
Name:RATLIFF, ABIGAIL GRACE (PHARMD)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:GRACE
Last Name:RATLIFF
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1511 PRAIRIE LN APT A
Mailing Address - Street 2:
Mailing Address - City:SEYMOUR
Mailing Address - State:TN
Mailing Address - Zip Code:37865-4498
Mailing Address - Country:US
Mailing Address - Phone:865-585-2378
Mailing Address - Fax:
Practice Address - Street 1:1511 PRAIRIE LN APT A
Practice Address - Street 2:
Practice Address - City:SEYMOUR
Practice Address - State:TN
Practice Address - Zip Code:37865-4498
Practice Address - Country:US
Practice Address - Phone:865-585-2378
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-10
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN47337183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist