Individual
RAVEN SIMONE JOHNSON
Active
Individual
RAVEN SIMONE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
D96164
MD
207L00000X
Anesthesiology Physician
MD491237C
PA
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
D96164
MD
Other
Enumeration date
03/28/2019
Last updated
08/22/2025
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