Individual provider · Type 1 NPI
Raven Ennis
Psychiatric/Mental Health Nurse Practitioner · Las Vegas, NV
NPI number
1407278757
Active
Practice location
4270 S Decatur Blvd Ste B6
Las Vegas, NV 89103-6802
Fax (702) 825-0091
Other practice locations
- 330 S Valley View Blvd, Las Vegas, NV 89107-4361 · (702) 759-0882
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Registered Nurse | 163W00000X | RN73437 (NV) |
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | APRN002372 (NV) |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
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About NPI 1407278757
Raven Ennis's National Provider Identifier is 1407278757, issued on Jan 6, 2014. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Las Vegas, NV. The record was last updated on Mar 22, 2021.