Provider Demographics
NPI:1336343805
Name:NINA RAVEY AND ASSOCIATES, INC.
Entity type:Organization
Organization Name:NINA RAVEY AND ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NINA
Authorized Official - Middle Name:
Authorized Official - Last Name:RAVEY
Authorized Official - Suffix:
Authorized Official - Credentials:MSN,RN,CNS,C-FNP,APR
Authorized Official - Phone:337-824-2078
Mailing Address - Street 1:711 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:JENNINGS
Mailing Address - State:LA
Mailing Address - Zip Code:70546-5311
Mailing Address - Country:US
Mailing Address - Phone:337-824-2078
Mailing Address - Fax:337-824-2004
Practice Address - Street 1:711 N MAIN ST
Practice Address - Street 2:
Practice Address - City:JENNINGS
Practice Address - State:LA
Practice Address - Zip Code:70546-5311
Practice Address - Country:US
Practice Address - Phone:337-824-2078
Practice Address - Fax:337-824-2004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1186759Medicaid
LAP21505Medicare UPIN
LA1186759Medicaid
LA5CB50Medicare PIN