Provider Demographics
NPI:1114960374
Name:RAVEN, KATHERINE P (MD)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:P
Last Name:RAVEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 12815
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89510-2815
Mailing Address - Country:US
Mailing Address - Phone:775-334-3941
Mailing Address - Fax:775-334-3450
Practice Address - Street 1:10 KIRMAN AVE
Practice Address - Street 2:WASHOE COUNTY CORONERS OFFICE
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502
Practice Address - Country:US
Practice Address - Phone:775-334-3941
Practice Address - Fax:775-334-3941
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NV8663207ZF0201X
WAMD00033131207ZF0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZF0201XAllopathic & Osteopathic PhysiciansPathologyForensic Pathology