Individual
RAVERN C ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
1935 MEDICAL DISTRICT DR, DALLAS, TX 75235-7701
(214) 456-7008
(214) 456-2897
Mailing address
1935 MEDICAL DISTRICT DR, DALLAS, TX 75235-7701
(214) 456-7008
(214) 456-2897
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
143466
MO
Other
Enumeration date
02/03/2009
Last updated
02/16/2012
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