person
Raven Custalow, AGPCNP-BC
Primary Care Nurse Practitioner in Aylett, Virginia
NPI 1669955019

Raven Custalow is a Primary Care Nurse Practitioner based in Aylett, VA and is specialized in Primary Care. Raven Custalow practices in Aylett, VA and has the professional credentials of AGPCNP-BC. The NPI Number for Raven Custalow is 1669955019 and holds a License No. 0024176579 (Virginia).

The current practice location address for Raven Custalow is 7864 Richmond Tappahannock Hwy, Aylett, VA and can be reached out via phone at 804-769-2015.

Location: 7864 Richmond Tappahannock Hwy, Aylett, VA, 23009-2912
person
Provider Profile Details
NPI Number
1669955019
Provider Name
Raven Custalow
Credential
AGPCNP-BC
Provider Entity Type
Individual
Gender
Female
Address
7864 Richmond Tappahannock Hwy, Aylett, VA, 23009-2912
Phone Number
804-769-2015
Fax Number
Provider Enumeration Date
09/12/2018
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
7864 Richmond Tappahannock Hwy
City
State
Zip
23009-3056
Phone Number
804-769-2015
Fax Number
person
Provider Business Mailing Address Details
Address
7864 Richmond Tappahannock Hwy
City
State
Zip
23009-3056
Phone Number
804-769-2015
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Primary Care
Taxonomy
License No.
0024176579 (Virginia)
Definition
Definition to come...
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