Provider Demographics
NPI:1770641565
Name:RATLIFFE-WARNER, PAMELA DIANE (MHPP)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:DIANE
Last Name:RATLIFFE-WARNER
Suffix:
Gender:F
Credentials:MHPP
Other - Prefix:
Other - First Name:PAMELA
Other - Middle Name:DIANE
Other - Last Name:RATLIFFE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MHPP
Mailing Address - Street 1:PO BOX 6430
Mailing Address - Street 2:
Mailing Address - City:SPRINGDALE
Mailing Address - State:AR
Mailing Address - Zip Code:72766-6430
Mailing Address - Country:US
Mailing Address - Phone:479-750-2020
Mailing Address - Fax:479-872-2441
Practice Address - Street 1:4960 SPRINGHOUSE DR.
Practice Address - Street 2:
Practice Address - City:SPRINGDALE
Practice Address - State:AR
Practice Address - Zip Code:72762
Practice Address - Country:US
Practice Address - Phone:479-750-2020
Practice Address - Fax:479-872-2441
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator