Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | 01470NP | OH |
NPI | 1083630966 |
---|---|
Provider Name | Ann Marie Raffis |
First Address | Highland Hills, OH 44122-7251 |
Second Address | Bedford, OH 44146-2709 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2006 |
Last Update Date | 08/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000221254 | UNISON (01) | OH |
000000509183 | ANTHEM (01) | OH |
2044737 | (05) | OH |
363933 | WELLCARE (01) | OH |
744852 | BUCKEYE (01) | OH |
7512638 | AETNA (01) | OH |
Q05703 | (02) |