Provider Demographics
NPI:1851516066
Name:RATLIFF, TRACIE LEE (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:TRACIE
Middle Name:LEE
Last Name:RATLIFF
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:MISS
Other - First Name:TRACIE
Other - Middle Name:LEE
Other - Last Name:HACKNEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 432
Mailing Address - Street 2:
Mailing Address - City:PIKEVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41502-0432
Mailing Address - Country:US
Mailing Address - Phone:606-430-2202
Mailing Address - Fax:606-218-7502
Practice Address - Street 1:911 BYPASS RD BLDG A
Practice Address - Street 2:
Practice Address - City:PIKEVILLE
Practice Address - State:KY
Practice Address - Zip Code:41501-1602
Practice Address - Country:US
Practice Address - Phone:606-430-2202
Practice Address - Fax:606-218-7502
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-14
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4015951363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily