Provider Demographics
NPI:1801287024
Name:RATLIFF, KASEY ASHCRAFT (PA-C)
Entity type:Individual
Prefix:
First Name:KASEY
Middle Name:ASHCRAFT
Last Name:RATLIFF
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:KASEY
Other - Middle Name:LYNN
Other - Last Name:ASHCRAFT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4101 CAMPUS RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28105-5077
Mailing Address - Country:US
Mailing Address - Phone:704-234-1943
Mailing Address - Fax:
Practice Address - Street 1:4101 CAMPUS RIDGE RD
Practice Address - Street 2:
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-5077
Practice Address - Country:US
Practice Address - Phone:704-234-1943
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-10
Last Update Date:2015-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC001005561363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant