Provider Demographics
NPI:1447882485
Name:RATLIFF, CHRISTOPHER JACKIE (FNP)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:JACKIE
Last Name:RATLIFF
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 CENTRE AVE NE
Mailing Address - Street 2:
Mailing Address - City:COEBURN
Mailing Address - State:VA
Mailing Address - Zip Code:24230-4023
Mailing Address - Country:US
Mailing Address - Phone:276-455-5556
Mailing Address - Fax:
Practice Address - Street 1:116 CENTRE AVE NE
Practice Address - Street 2:
Practice Address - City:COEBURN
Practice Address - State:VA
Practice Address - Zip Code:24230
Practice Address - Country:US
Practice Address - Phone:276-455-5556
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-07
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024178816363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0024178816OtherSTATE LICENSE