| 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 |