Provider Demographics
NPI:1780198762
Name:RATLIFF, ANDREW B JR (FNP-BC)
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:B
Last Name:RATLIFF
Suffix:JR
Gender:M
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3150 HORTON RD
Mailing Address - Street 2:
Mailing Address - City:FOREST HILL
Mailing Address - State:TX
Mailing Address - Zip Code:76119-5905
Mailing Address - Country:US
Mailing Address - Phone:817-413-3425
Mailing Address - Fax:
Practice Address - Street 1:3150 HORTON RD
Practice Address - Street 2:
Practice Address - City:FOREST HILL
Practice Address - State:TX
Practice Address - Zip Code:76119-5905
Practice Address - Country:US
Practice Address - Phone:817-413-3425
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-29
Last Update Date:2017-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP135744363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXAP135744OtherFAMILY NURSE PRACTITIONER