Provider Demographics
NPI:1831439116
Name:MCRAVEN, JAMES WESLEY (APN, FNP)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:WESLEY
Last Name:MCRAVEN
Suffix:
Gender:M
Credentials:APN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2314 E 28TH ST
Mailing Address - Street 2:
Mailing Address - City:HOPE
Mailing Address - State:AR
Mailing Address - Zip Code:71801-1088
Mailing Address - Country:US
Mailing Address - Phone:870-826-4620
Mailing Address - Fax:
Practice Address - Street 1:210 N. STATELINE
Practice Address - Street 2:SUITE 301
Practice Address - City:TEXARKANA
Practice Address - State:AR
Practice Address - Zip Code:71854
Practice Address - Country:US
Practice Address - Phone:870-773-2621
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-22
Last Update Date:2013-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA003826363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily