Provider Demographics
NPI:1285369033
Name:PIERRE, RAVEN (RN)
Entity type:Individual
Prefix:
First Name:RAVEN
Middle Name:
Last Name:PIERRE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1768 FM 1362 N
Mailing Address - Street 2:
Mailing Address - City:CALDWELL
Mailing Address - State:TX
Mailing Address - Zip Code:77836-6595
Mailing Address - Country:US
Mailing Address - Phone:979-595-7099
Mailing Address - Fax:
Practice Address - Street 1:1768 FM 1362 N
Practice Address - Street 2:
Practice Address - City:CALDWELL
Practice Address - State:TX
Practice Address - Zip Code:77836-6595
Practice Address - Country:US
Practice Address - Phone:979-595-7099
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-17
Last Update Date:2022-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX949487163WW0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WW0101XNursing Service ProvidersRegistered NurseWomen's Health Care, Ambulatory