Provider Demographics
NPI:1063560506
Name:RAVEN, KAREN ANN (MD)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:ANN
Last Name:RAVEN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:6512 S MCCARRAN BLVD STE D
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89509-6141
Mailing Address - Country:US
Mailing Address - Phone:775-826-1285
Mailing Address - Fax:775-284-4093
Practice Address - Street 1:6512 S MCCARRAN BLVD STE D
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-6141
Practice Address - Country:US
Practice Address - Phone:775-826-1285
Practice Address - Fax:775-284-4093
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2017-10-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NV6108207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVCC0886OtherBLUECROSS BLUE SHIELD
NVE62045Medicare UPIN
NVCC0886OtherBLUECROSS BLUE SHIELD