| NPI | 1467967687 |
|---|---|
| Former Name | RAVEN TRICKETT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: OH 506589) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: OH 166401) |
| Enumeration Date | 2017-12-11 |
| Last Update Date | 2022-06-21 |