EMILY SUE RAVEN (NPI# 1154738805) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154738805 |
| Entity Type | Individual |
| Full Name | EMILY SUE RAVEN |
| Credential | PA-C |
| Practice Address |
8611 W Point Douglas Rd S Cottage Grove MN 55016 |
| Mailing Address |
2925 Chicago Ave Minneapolis MN 55407-1321 |
| Practice Telephone | 6514881884 |
| Mailing Telephone | 6122625000 |
| Enumeration Date | 2014-07-15 |
| Last Update Date | 2019-12-03 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 13145 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363A00000X | Physician Assistant | 074338 | IA | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 8611 W Point Douglas Rd S, Cottage Grove, MN 55016 | 6514881884 |
| Street Address |
8611 W POINT DOUGLAS RD S |
| City | COTTAGE GROVE |
| State | MN |
| Zip Code | 55016 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831168236 | Naomi P. Tetzlaff | Family Medicine | 8611 W Point Douglas Rd S, Cottage Grove, MN 55016-4005 | 2006-03-16 |
| 1639680473 | Vanessa Boerhave | Psychologist | 8611 W Point Douglas Rd S, Cottage Grove, MN 55016 | 2017-10-19 |
| 1265853220 | Anjanette Finnegan | Pharmacist | 8611 W Point Douglas Rd S, Cottage Grove, MN 55016-4005 | 2013-12-18 |
| 1982952909 | Ekaterina Peterson | Physician Assistant | 8611 W Point Douglas Rd S, Cottage Grove, MN 55016-4005 | 2012-08-23 |
| 1750648671 | Victoria Chiou | Family Medicine | 8611 W Point Douglas Rd S, Cottage Grove, MN 55016-4005 | 2012-04-17 |
| 1568768919 | Allina Health System | Clinic/Center | 8611 W Point Douglas Rd S, Cottage Grove, MN 55016-4005 | 2011-02-02 |
| 1285893594 | James P Mantzaris | Family Medicine | 8611 W Point Douglas Rd S, Cottage Grove, MN 55016-4005 | 2008-06-03 |
| 1508885914 | Walid A Mikhail | Family Medicine | 8611 W Point Douglas Rd S, Cottage Grove, MN 55016-4005 | 2006-07-18 |
| 1972569408 | Alison Mary Peterson | Family Medicine | 8611 W Point Douglas Rd S, Cottage Grove, MN 55016-4005 | 2006-04-24 |
| 1851355135 | Allina Health System | Pharmacy | 8611 W Point Douglas Rd S, Cottage Grove, MN 55016-4005 | 2006-04-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073161519 | Kathleen Johnson | Technician | 7436 Hinton Park Ave South, Cottage Grove, MN 55016 | 2019-08-28 |
| 1710473434 | Cg Care Center, LLC. | Skilled Nursing Facility | 6993 80th Street South, Cottage Grove, MN 55016 | 2018-07-05 |
| 1235532771 | Lydia Sirucek | Nurse Practitioner | 8611 E Point Douglas Rd, Cottage Grove, MN 55016 | 2014-09-29 |
| 1366859746 | Home Care Service Providers Inc. | Home Health | 9635 Hamlet Ave, Cottage Grove, MN 55016 | 2014-07-17 |
| 1942622089 | Wal-mart Stores, Inc. | Technician/Technologist | 9300 East Point Douglas Rd S, Cottage Grove, MN 55016 | 2014-01-08 |
| 1255770962 | Southside At The Cottage Grove Site | Family Medicine | 8454 East Point Douglas Road, Cottage Grove, MN 55016 | 2013-06-17 |
| 1710222088 | Santori Chiropractic Center, LLC | Chiropractor | 7155 80th Street So, Cottage Grove, MN 55016 | 2012-11-28 |
| 1609151414 | Kenneth Nworah Okafor | Pharmacist | 7015 East Point Douglas Road, Cottage Grove, MN 55016 | 2011-10-13 |
| 1134432925 | Elizabeth Frances Rezek | Social Worker | 8813 Hale Ave S, Cottage Grove, MN 55016 | 2010-07-21 |
| 1841420882 | Mark Joseph Mangine | Physical Therapist | 6936 Pine Arbor Dr S Ste 150, Cottage Grove, MN 55016 | 2009-07-24 |
| Find all providers in zip 55016 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326595091 | Anna Marie Mukaria | Physician Assistant | 7280 E Point Douglas Rd S, Cottage Grove, MN 55016-3016 | 2016-09-09 |
| 1467410902 | Susan Kees Johnson | Physician Assistant | 251 E Cottage Grove Rd, Cottage Grove, WI 53527-9619 | 2006-05-03 |
| 1154586717 | Kathleen Anne Knipfer | Physician Assistant | 251 E Cottage Grove Rd, Cottage Grove, WI 53527-9619 | 2008-07-23 |
| 1932281656 | William Vogel | Physician Assistant | 1445 Gateway Blvd, Cottage Grove, OR 97424-1224 | 2006-10-20 |
| 1093778540 | Louis A Falligant | Physician Assistant | 500 Westlawn Dr, Cottage Grove, WI 53527-9106 | 2006-04-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588265284 | Foua Vang | Physician Assistant | 689 County Road D E Apt 302, Saint Paul, MN 55117-1263 | 2020-11-08 |
| 1043811870 | Leiah Hoffman | Physician Assistant | 4243 Timberridge Ln Apt A, Hermantown, MN 55811-4047 | 2020-11-06 |
| 1760083059 | Amanda Hanover | Physician Assistant | 10346 Mississippi Blvd Nw, Coon Rapids, MN 55433-4521 | 2020-11-04 |
| 1780284844 | Lily Ganz | Physician Assistant | 2737 Huntington Ave, St Louis Park, MN 55416-3917 | 2020-10-28 |
| 1972103000 | Jaclyn Ann Bautch | Physician Assistant | 24721 State Highway 15, Saint Augusta, MN 56301-9211 | 2020-10-28 |
| 1801496047 | Tanner Vaughn Kramp | Physician Assistant | 3450 Wild Turkey Rd, Red Wing, MN 55066-1762 | 2020-10-27 |
| 1497354955 | Sarah Marti | Physician Assistant | 810 Thornton St Se Apt 904, Minneapolis, MN 55414-3652 | 2020-10-25 |
| 1598364473 | Kylee N Persing | Physician Assistant | 10 4th Ave S, Saint Cloud, MN 56301-3614 | 2020-10-21 |
| 1073112009 | Reece Edward Mcevoy | Physician Assistant | 2638 Sand Trap Rd Se, Rochester, MN 55904-3904 | 2020-10-21 |
| 1679189021 | Anne Elizabeth Drabot | Physician Assistant | 4741 Vincent Ave S, Minneapolis, MN 55410-1843 | 2020-09-21 |
| Find all providers with the same taxonomy | ||||
| City | COTTAGE GROVE |
| Zip Code | 55016 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.