Individual
MICHELLE MARIE RATLIFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5901 HARPER DR NE, ALBUQUERQUE, NM 87109-3587
(505) 823-8233
(505) 823-8059
Mailing address
PO BOX 26666, PHS PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-6770
(505) 923-5354
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA2004-0049
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
22626859
—
NM
Enumeration date
07/21/2006
Last updated
03/15/2016
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