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1265290837
RAVEN EBANEZ
PRESTON, ID
NPI
1265290837
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: ID 59770)
Enumeration Date
2024-03-08
Last Update Date
2024-05-15
Business Address
RAVEN EBANEZ APRN-CNP
44 N 1ST E
PRESTON, ID 83263-1326
Phone number: 208-852-2900
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Mailing Address
RAVEN EBANEZ APRN-CNP
44 N 1ST E
PRESTON, ID 83263-1326
Phone number: 208-852-4100
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