RAVEN ENNIS NPI 1407278757

NPI Information

NPI: 1407278757
Provider Name: RAVEN ENNIS
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Individual

Specialization: Psychiatric/Mental Health

Organization: ALLIANCE MENTAL HEALTH SPECIALISTS SUBA PARK PIERSON PLLC

PECOS Registration: Yes

Address:
4270 S DECATUR BLVD STE B6
LAS VEGAS, NV
ZIP 89103
Phone: (702) 485-2100
Get Directions

Raven Ennis is a psychiatric/mental health nurse practitioner in Las Vegas, NV with 12 years of experience. Raven Ennis NPI is 1407278757. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: UNIVERSITY OF NEVADA SCHOOL OF MEDICINE
Graduation Year:2012

The provider's business location address is:

4270 S DECATUR BLVD STE B6
LAS VEGAS, NV
ZIP 89103-802
Phone: (702) 485-2100
Fax: (702) 825-0091

The NPI 1407278757 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 1/6/2014 and was last updated on 3/22/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	163W00000X	Registered Nurse		RN73437	NEVADA	No
2	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	APRN002372	NEVADA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

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