Individual provider · Type 1 NPI

Stacy Diane Raverty, RN

Gerontology Registered Nurse · Mankato, MN

NPI number 1700716784 Active

Practice location

104 Meray Blvd
Mankato, MN 56001-4345

Call (507) 387-2037 Map

Fax (507) 387-2061

Specialties and licenses

Taxonomy	Code	License
Gerontology Registered Nurse Primary	163WG0600X	1352210 (MN)

Gerontology Registered Nurse: Definition to come...

About NPI 1700716784

Stacy Diane Raverty, RN's National Provider Identifier is 1700716784, issued on May 21, 2026. The primary taxonomy on file is Gerontology Registered Nurse (163WG0600X), and the practice location is in Mankato, MN. The record was last updated on May 21, 2026.