Provider Demographics
NPI:1851991889
Name:RATLEY, ALISSA DIANNE MOREHEAD (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ALISSA
Middle Name:DIANNE MOREHEAD
Last Name:RATLEY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3550 JAMES SANDERS BLVD
Mailing Address - Street 2:
Mailing Address - City:PADUCAH
Mailing Address - State:KY
Mailing Address - Zip Code:42001-9159
Mailing Address - Country:US
Mailing Address - Phone:270-444-6992
Mailing Address - Fax:
Practice Address - Street 1:3550 JAMES SANDERS BLVD
Practice Address - Street 2:
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42001-9159
Practice Address - Country:US
Practice Address - Phone:270-444-6992
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-28
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY016132183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist