Provider Demographics
NPI:1871386367
Name:DAWKINS, RAVEN
Entity type:Individual
Prefix:MS
First Name:RAVEN
Middle Name:
Last Name:DAWKINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4602 WESTGROVE CT STE C
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23455-5458
Mailing Address - Country:US
Mailing Address - Phone:757-776-8180
Mailing Address - Fax:757-776-8180
Practice Address - Street 1:4602 WESTGROVE CT STE C
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23455-5458
Practice Address - Country:US
Practice Address - Phone:757-776-8180
Practice Address - Fax:757-776-8180
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-27
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAHCO0005831253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care