NPI | 1215491261 |
---|---|
Former Name | RAVEN P OSSIVAND |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71009712A) |
Additional Taxonomies | 163WE0003X Registered Nurse, Emergency (Licence: IN 28195639A) |
363L00000X Nurse Practitioner (Licence: IN 71009712A) | |
Enumeration Date | 2019-01-24 |
Last Update Date | 2024-02-13 |