Provider Demographics
NPI:1497403091
Name:RAVER, HILLARY ROSE
Entity Type:Individual
Prefix:
First Name:HILLARY
Middle Name:ROSE
Last Name:RAVER
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 1:4211 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LINEBORO
Mailing Address - State:MD
Mailing Address - Zip Code:21102-3124
Mailing Address - Country:US
Mailing Address - Phone:443-821-1609
Mailing Address - Fax:
Practice Address - Street 1:4211 MAIN ST
Practice Address - Street 2:
Practice Address - City:LINEBORO
Practice Address - State:MD
Practice Address - Zip Code:21102-3124
Practice Address - Country:US
Practice Address - Phone:443-821-1609
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-13
Last Update Date:2022-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife