Individual
LENA RAVENELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4755 OGLETOWN STANTON ROAD, SUITE 5A43, NEWARK, DE 19718-2200
(302) 623-0188
(302) 733-5640
Mailing address
6607 LAKE HILL DR APT H, RALEIGH, NC 27609-3424
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
C0009681
MD
363A00000X
Physician Assistant
Primary
C5-0012125
DE
Other
Enumeration date
11/08/2023
Last updated
12/17/2024
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