Individual
RAVEN N NILES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
732 13TH AVE, CORALVILLE, IA 52241-1737
(319) 330-3712
Mailing address
732 13TH AVE, CORALVILLE, IA 52241-1737
(319) 330-3712
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
G158269
IA
Other
Enumeration date
04/12/2020
Last updated
04/12/2020
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