Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 3808 | TN |
N | 207K00000X | Allergist & Immunologist | E-14133 | AR |
NPI | 1023462868 |
---|---|
Provider Name | Amy Elizabeth Ragsdale |
First Address | Louisville, KY 40223-2992 |
Second Address | Memphis, TN 38119-4810 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2016 |
Last Update Date | 25/05/2021 |