Individual
DEREK WILLIAM RATLIFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN, PMHNP
Contact information
Practice address
425 BROADWAY ST STE 101, PADUCAH, KY 42001-0713
(270) 442-7121
Mailing address
425 BROADWAY ST, PADUCAH, KY 42001-0713
(270) 442-7121
(270) 443-9692
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
3015461
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100710080
—
KY
Enumeration date
11/11/2020
Last updated
02/15/2024
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