Individual
BROOKE RATCLIFFE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
720 ESKENAZI AVE, INDIANAPOLIS, IN 46202-5187
(317) 880-7666
(317) 880-0448
Mailing address
PO BOX 637764, CINCINNATI, OH 45263-7764
(317) 880-3939
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
28221230C
IN
363L00000X
Nurse Practitioner
Primary
71013378A
IN
363LA2100X
Acute Care Nurse Practitioner
71013378A
IN
363LG0600X
Gerontology Nurse Practitioner
71013378A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1102797670
ANTHEM PTAN
IN
05
—
300070732
—
IN
Enumeration date
10/09/2021
Last updated
09/29/2025
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