Provider Demographics
NPI:1316258403
Name:RATLIFF, JENETTE DENISE (RN, BSN)
Entity type:Individual
Prefix:MRS
First Name:JENETTE
Middle Name:DENISE
Last Name:RATLIFF
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:MRS
Other - First Name:JENETTE
Other - Middle Name:DENISE
Other - Last Name:SLAUGHTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, BSN
Mailing Address - Street 1:13035 W VISTA PASEO DR
Mailing Address - Street 2:
Mailing Address - City:LITCHFIELD PARK
Mailing Address - State:AZ
Mailing Address - Zip Code:85340-5572
Mailing Address - Country:US
Mailing Address - Phone:602-471-1924
Mailing Address - Fax:
Practice Address - Street 1:13657 W MCDOWELL RD
Practice Address - Street 2:SUITE 118
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85395-2601
Practice Address - Country:US
Practice Address - Phone:602-471-1924
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-23
Last Update Date:2010-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN137221163W00000X, 163WW0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WW0000XNursing Service ProvidersRegistered NurseWound Care
No163W00000XNursing Service ProvidersRegistered Nurse