RAVEN DEDRICK WENTWORTH APRN NPI 1952352098

NPI Information

  • NPI: 1952352098
  • Provider Name: RAVEN DEDRICK WENTWORTH, APRN
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 847 SQUIRREL HOLLOW DR
    LINDEN, TN
    ZIP 37096
  • Phone: (931) 589-2600

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NPI Details

Raven Dedrick Wentworth, APRN is a family nurse practitioner in Linden, TN. Raven Dedrick Wentworth, APRN NPI is 1952352098. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

847 SQUIRREL HOLLOW DR
LINDEN, TN
ZIP 37096-479
Phone: (931) 589-2600

The NPI 1952352098 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Power Mobility Devices.

The enumeration date for this NPI number is 5/13/2006 and was last updated on 11/10/2016.

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
1363LA2200XNurse PractitionerAdult HealthAPN11711TENNESSEENo
2363LF0000XNurse PractitionerFamily11711TENNESSEEYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
13642779MEDICAIDTENNESSEE
2Q65100MEDICARE UPINTENNESSEE

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: 11/21/2025

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