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Individual

MRS. DIANNE MARIE RAFFERTY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNP

Contact information

Practice address
54 SOUTH STATE ST, STE 203, PAINESVILLE, OH 44077
(440) 352-0608
(440) 352-0640
Mailing address
2980 LEGEND LN, WICKLIFFE, OH 44092-2800
(440) 944-0805

Taxonomy

Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
NP07313
OH
363LW0102X
Women's Health Nurse Practitioner
RN155127
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2411429
OH
Enumeration date
11/16/2005
Last updated
10/26/2015
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