Provider Demographics
NPI:1134972110
Name:RAQUID, SWEET FAYE (FNP-C)
Entity type:Individual
Prefix:
First Name:SWEET FAYE
Middle Name:
Last Name:RAQUID
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 1:4059 MENLO AVE APT 3
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92105-1920
Mailing Address - Country:US
Mailing Address - Phone:619-560-2138
Mailing Address - Fax:
Practice Address - Street 1:4059 MENLO AVE APT 3
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92105-1920
Practice Address - Country:US
Practice Address - Phone:619-560-2138
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-09
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANPF95029690363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily