Provider Demographics
NPI:1508644303
Name:RATELIFF, LINDA (CNP)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:
Last Name:RATELIFF
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8650 ALAMEDA BLVD NE STE 101E
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87122-3791
Mailing Address - Country:US
Mailing Address - Phone:505-255-1866
Mailing Address - Fax:505-255-1852
Practice Address - Street 1:8650 ALAMEDA BLVD NE STE 101E
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87122-3791
Practice Address - Country:US
Practice Address - Phone:505-255-1866
Practice Address - Fax:505-255-1852
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-21
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM75591363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty