Provider Demographics
NPI:1477556538
Name:RATLIFF, SHERI LYNNE (ACNP)
Entity Type:Individual
Prefix:
First Name:SHERI
Middle Name:LYNNE
Last Name:RATLIFF
Suffix:
Gender:F
Credentials:ACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:134 WOOTON ST
Mailing Address - Street 2:
Mailing Address - City:HAZARD
Mailing Address - State:KY
Mailing Address - Zip Code:41701-1554
Mailing Address - Country:US
Mailing Address - Phone:606-439-0966
Mailing Address - Fax:606-487-7407
Practice Address - Street 1:200 MEDICAL CENTER DR
Practice Address - Street 2:SUITE 2D
Practice Address - City:HAZARD
Practice Address - State:KY
Practice Address - Zip Code:41701-9466
Practice Address - Country:US
Practice Address - Phone:606-487-7403
Practice Address - Fax:606-487-7407
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3311P363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY78004793Medicaid
KY78004793Medicaid
KYP21705Medicare UPIN