Individual
CORINNE ATARAXIA RAVENWALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1140 WHITE BEAR AVE N, SAINT PAUL, MN 55106-3004
(651) 888-7630
Mailing address
1140 WHITE BEAR AVE N, SAINT PAUL, MN 55106-3004
(651) 888-7630
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
1380156
MN
Other
Enumeration date
06/06/2025
Last updated
06/06/2025
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