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Individual

MS. RAVEN MODISETTE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP-C,PMHNP-BC

Contact information

Practice address
3901 ARLINGTON HIGHLANDS BLVD, STE 200, ARLINGTON, TX 76018-6050
(817) 695-5035
Mailing address
3901 ARLINGTON HIGHLANDS BLVD, STE 200, ARLINGTON, TX 76018-6050
(817) 695-5035
(817) 695-5037

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
AP137299
TX
363LF0000X
Family Nurse Practitioner
AP137299
TX
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP137299
TX

Other

Enumeration date
10/26/2016
Last updated
06/17/2022
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