RAVEN FULGHAM (NPI# 1598275687) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598275687 |
| Entity Type | Individual |
| Full Name | RAVEN FULGHAM |
| Credential | FNP-C |
| Practice Address |
5818 Harbour View Blvd Ste 240 Suffolk VA 23435-3315 |
| Mailing Address |
1216 Hampton Blvd Apt 4 Norfolk VA 23517-1855 |
| Practice Telephone | 7574836100 |
| Mailing Telephone | 7572851826 |
| Enumeration Date | 2017-10-03 |
| Last Update Date | 2017-10-03 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
0024175269 | VA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
5818 HARBOUR VIEW BLVD STE 240 |
| City | SUFFOLK |
| State | VA |
| Zip Code | 23435-3315 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669418174 | Tracy L Knaak | Physician Assistant | 5818 Harbour View Blvd Ste 240, Suffolk, VA 23435-3315 | 2006-06-22 |
| 1700139391 | Maryview Hospital | Surgery | 5818 Harbour View Blvd Ste 240, Suffolk, VA 23435-3315 | 2012-10-19 |
| 1588810519 | Christy Wild | Physician Assistant | 5818 Harbour View Blvd Ste 240, Suffolk, VA 23435-3315 | 2008-08-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902423700 | Sean Eric Surber | Physical Therapist | 5818 D Harbour View Blvd., Suite 150, Suffolk, VA 23435 | 2020-06-29 |
| 1871158691 | Lumen Flux Pllc | Dentist | 5501 Bennett's Pasture Road, Suite D, Suffolk, VA 23435 | 2019-05-07 |
| 1588175970 | Louisa Catherine Korte | Anesthesiology | 3107 Summerhouse Drive, Suffolk, VA 23435 | 2017-10-12 |
| 1134648686 | Nicole Short Brown | Non-emergency Medical Transport (VAN) | 782 D Bennetts Meadow Lane, Suffolk, VA 23435 | 2017-09-15 |
| 1104346923 | Southerncare, Inc. | Hospice Care, Community Based | 1037 Champions Way Ste 600, Suffolk, VA 23435 | 2017-06-22 |
| 1801245329 | Usn | Military Hospital | 3602 Traverse Circle, Suffolk, VA 23435 | 2016-06-06 |
| 1366836173 | Vernon Johnson | Counselor | 6805 Castlewood Avenue, Suffolk, VA 23435 | 2015-03-19 |
| 1265776751 | Sister's Developing Growth & Change, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 6101 Bradford Drive #b, Suffolk, VA 23435 | 2012-11-21 |
| 1770899247 | Lefcoe, Weinstein, Sachs, Schiff & Associates | Dentist | 210 Meadow View Boulevard, Suffolk, VA 23435 | 2010-08-23 |
| 1770805178 | Nikkiah Wyatt Smith | Counselor | 5705 Lee Farm Ln Ste D, Suffolk, VA 23435 | 2010-02-25 |
| Find all providers in zip 23435 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912512799 | Jessica Eve Taylor | Nurse Practitioner | 1013 University Blvd Ste 270, Suffolk, VA 23435-3900 | 2020-09-09 |
| 1205465986 | Deja Davis | Nurse Practitioner | 150 Burnetts Way Ste 320, Suffolk, VA 23434-8288 | 2020-04-05 |
| 1245883693 | Taylor Brockman | Nurse Practitioner | 148 Burnetts Way Ste 107, Suffolk, VA 23434-6149 | 2019-07-24 |
| 1831660554 | April Jones | Nurse Practitioner | 273 Jonathans Way, Suffolk, VA 23434-9171 | 2018-12-06 |
| 1073092599 | Michelle Melton | Nurse Practitioner | 2790 Godwin Blvd Ste 205, Suffolk, VA 23434-8154 | 2018-08-07 |
| 1356851851 | Tiffany Darden | Nurse Practitioner | 2204 Arizona Ave, Suffolk, VA 23434-2704 | 2017-10-10 |
| 1699215475 | April Hartless | Nurse Practitioner | 1005 Commercial Ln Ste 220, Suffolk, VA 23434-8149 | 2017-02-28 |
| 1376082362 | Ashley Witt Rice | Nurse Practitioner | 100 Cherry Grove Rd N, Suffolk, VA 23432 | 2017-02-23 |
| 1518418961 | Emily Massaro | Nurse Practitioner | 5839 Harbour View Blvd Ste 201, Suffolk, VA 23435-3797 | 2016-10-20 |
| 1336525823 | Np Xpress Housecall Medical Practice | Nurse Practitioner | 3109 Melrose Ct, Suffolk, VA 23434-7279 | 2015-08-06 |
| Find all providers in SUFFOLK | ||||
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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.