Individual
RAVEN L NIX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
720 ESKENAZI AVE, INDIANAPOLIS, IN 46202-5187
(317) 880-7666
(317) 880-0448
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
28184480A
IN
363LF0000X
Family Nurse Practitioner
Primary
40113
TN
363LF0000X
Family Nurse Practitioner
71005555A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1821470238
ANTHEM PTAN
IN
05
—
201306800
—
IN
Enumeration date
06/22/2015
Last updated
11/25/2025
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