Provider Demographics
NPI:1912634155
Name:RATCLIFF, ALYSSA ANN (APRN)
Entity Type:Individual
Prefix:
First Name:ALYSSA
Middle Name:ANN
Last Name:RATCLIFF
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MS
Other - First Name:ALYSSA
Other - Middle Name:ANN
Other - Last Name:RATCLIFF
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:301 HARBOUR CLOSE UNIT 202
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06519-2862
Mailing Address - Country:US
Mailing Address - Phone:913-626-7882
Mailing Address - Fax:
Practice Address - Street 1:1587 BOSTON POST RD
Practice Address - Street 2:
Practice Address - City:WESTBROOK
Practice Address - State:CT
Practice Address - Zip Code:06498-2090
Practice Address - Country:US
Practice Address - Phone:860-391-8840
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-08
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT10826363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner