Provider Demographics
NPI:1508434796
Name:RATLIFF, COURTNEY BREANA (MBA, ADM, MPM)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:BREANA
Last Name:RATLIFF
Suffix:
Gender:F
Credentials:MBA, ADM, MPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9160 LAKESIDE WAY
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30506-6224
Mailing Address - Country:US
Mailing Address - Phone:770-205-5353
Mailing Address - Fax:
Practice Address - Street 1:9160 LAKESIDE WAY
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30506-6224
Practice Address - Country:US
Practice Address - Phone:770-205-5353
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-14
Last Update Date:2021-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376G00000XNursing Service Related ProvidersNursing Home Administrator
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider
No374U00000XNursing Service Related ProvidersHome Health Aide