Provider Demographics
NPI:1336973098
Name:RATLIFF, CHAMBRE PATRICE (NP)
Entity type:Individual
Prefix:
First Name:CHAMBRE
Middle Name:PATRICE
Last Name:RATLIFF
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 ROOSEVELT MAGEE RD
Mailing Address - Street 2:
Mailing Address - City:TYLERTOWN
Mailing Address - State:MS
Mailing Address - Zip Code:39667-7177
Mailing Address - Country:US
Mailing Address - Phone:601-563-5113
Mailing Address - Fax:
Practice Address - Street 1:778 LIBERTY RD
Practice Address - Street 2:
Practice Address - City:FLOWOOD
Practice Address - State:MS
Practice Address - Zip Code:39232-9300
Practice Address - Country:US
Practice Address - Phone:769-243-6141
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-27
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS906854363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily