Basic Information
| Provider Information | |||||||||
| NPI: | 1477524510 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RATLIFF | ||||||||
| FirstName: | JULIE | ||||||||
| MiddleName: | F | ||||||||
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| Credential: | CFNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 501 W SAINT MARY BLVD | ||||||||
| Address2: | STE 200 | ||||||||
| City: | LAFAYETTE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 705064600 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3372357898 | ||||||||
| FaxNumber: | 3372357445 | ||||||||
| Practice Location | |||||||||
| Address1: | 501 W SAINT MARY BLVD | ||||||||
| Address2: | STE 200 | ||||||||
| City: | LAFAYETTE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 705064600 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3372357898 | ||||||||
| FaxNumber: | 3372357445 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/27/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | RN045447 | LA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
ID Information
| ID | Type | State | Issuer | Description | 1127621 | 05 | LA | MEDICAID |