| NPI | 1225580293 |
|---|---|
| Professional Name | RAVEN MODISETTE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX AP137299) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX AP137299) |
| 363L00000X Nurse Practitioner (Licence: TX AP137299) | |
| Enumeration Date | 2016-10-26 |
| Last Update Date | 2022-06-17 |