Provider Demographics
NPI:1942632765
Name:RAVER, KATHERINE CHOE (FNP-C)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:CHOE
Last Name:RAVER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8400 OSUNA RD NE STE 5C
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87111-2072
Mailing Address - Country:US
Mailing Address - Phone:505-585-2345
Mailing Address - Fax:505-800-5030
Practice Address - Street 1:8400 OSUNA RD NE STE 5C
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87111-2072
Practice Address - Country:US
Practice Address - Phone:505-585-2345
Practice Address - Fax:505-800-5030
Is Sole Proprietor?:No
Enumeration Date:2013-08-02
Last Update Date:2020-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCNP-03063363LF0000X
TX2476363LF0000X
TXAP124143363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMCNP-03063OtherAPRN LICENSE
TX852925OtherTX LICENSE
TX852925OtherTX LICENSE