Provider Demographics
NPI:1245977735
Name:RAVENSCRAFT, DUANE
Entity type:Individual
Prefix:
First Name:DUANE
Middle Name:
Last Name:RAVENSCRAFT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 LAIRD AVE
Mailing Address - Street 2:
Mailing Address - City:WHEATLAND
Mailing Address - State:PA
Mailing Address - Zip Code:16161-1134
Mailing Address - Country:US
Mailing Address - Phone:724-734-0373
Mailing Address - Fax:
Practice Address - Street 1:7741 PARK PL
Practice Address - Street 2:
Practice Address - City:MASURY
Practice Address - State:OH
Practice Address - Zip Code:44438-9700
Practice Address - Country:US
Practice Address - Phone:330-301-1059
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-16
Last Update Date:2022-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide