Individual
RAVEN CORNISH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4922 WHITTIER BLVD, LOS ANGELES, CA 90022-3115
(323) 201-9343
Mailing address
626 TOPSAIL DR, VILLA RICA, GA 30180-2319
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
95011126
CA
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
APRN-NP711759
GA
Other
Enumeration date
10/13/2019
Last updated
03/25/2026
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