Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223D0001X | Dental Public Health | 5204 | LA |
Y | 1223G0001X | General Practice | 5204 | LA |
Y | 213EG0000X | General Practice | 5204 | LA |
NPI | 1649395807 |
---|---|
Provider Name | Catrina Ratliff |
First Address | Clinton, LA 70722-0395 |
Second Address | Clinton, LA 70722-3210 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2007 |
Last Update Date | 17/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1852040 | (05) | LA |