Basic Information
Provider Information
NPI: 1164647574
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RATCLIFFE
FirstName: SUSAN
MiddleName: K
NamePrefix:  
NameSuffix:  
Credential: CNS
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 24730
Address2:  
City: NASHVILLE
State: TN
PostalCode: 37202
CountryCode: US
TelephoneNumber: 6153862300
FaxNumber: 6153862399
Practice Location
Address1: 5201 CHARLOTTE AVE
Address2:  
City: NASHVILLE
State: TN
PostalCode: 37209
CountryCode: US
TelephoneNumber: 6152221900
FaxNumber: 6152221917
Other Information
ProviderEnumerationDate: 04/13/2007
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
364SP0809X66791TNY Physician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsych/Mental Health, Adult

No ID Information.


Home