Provider Demographics
NPI:1508582065
Name:RATLEY, TAMARA KAY
Entity Type:Individual
Prefix:MRS
First Name:TAMARA
Middle Name:KAY
Last Name:RATLEY
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 1:8190 APAWANA CT
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45255-2501
Mailing Address - Country:US
Mailing Address - Phone:513-633-4055
Mailing Address - Fax:
Practice Address - Street 1:8190 APAWANA CT
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45255-2501
Practice Address - Country:US
Practice Address - Phone:513-633-4055
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-17
Last Update Date:2022-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1736940Medicaid