Provider Demographics
NPI:1972217685
Name:RIVERS, RAVEN J (DOULA)
Entity Type:Individual
Prefix:
First Name:RAVEN
Middle Name:J
Last Name:RIVERS
Suffix:
Gender:F
Credentials:DOULA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 LAMORE DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31907-3402
Mailing Address - Country:US
Mailing Address - Phone:706-580-9793
Mailing Address - Fax:
Practice Address - Street 1:2200 LAMORE DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31907-3402
Practice Address - Country:US
Practice Address - Phone:706-580-9793
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-09
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula