Provider Demographics
NPI:1982804530
Name:RATCLIFF, JUDY RENEE
Entity Type:Individual
Prefix:MRS
First Name:JUDY
Middle Name:RENEE
Last Name:RATCLIFF
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14931 LOFTON DR
Mailing Address - Street 2:
Mailing Address - City:CHANNELVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:77530-3227
Mailing Address - Country:US
Mailing Address - Phone:832-428-8729
Mailing Address - Fax:281-457-6923
Practice Address - Street 1:14931 LOFTON ST
Practice Address - Street 2:
Practice Address - City:CHANNELVIEW
Practice Address - State:TX
Practice Address - Zip Code:77530-3227
Practice Address - Country:US
Practice Address - Phone:832-428-8729
Practice Address - Fax:281-457-6923
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-23
Last Update Date:2007-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX107866164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse