NPI | 1386864619 |
---|---|
Former Name | CRYSTAL RAVENEL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OH np09333) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH 09333) |
Enumeration Date | 2007-04-27 |
Last Update Date | 2022-08-05 |