Doctor Name: | CORI ELIZABETH RAIKEN |
NPI Number: | 1104220292 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | ARNP |
License Number: | ARNP9311068 |
Business Practice Address: | 905 Lake Lily Dr Apt C432 Maitland, FL - 327517680 |
Business Phone Number: | 4074560757 |
Business Fax Number: | |
Mailing Address: | 905 Lake Lily Dr Apt C432, MAITLAND |
State: | FL |
Postal Code: | 327517680 |
Phone Number: | 4074560757 |
Fax Number: | |
NPI Enumeration Date: | 10/17/2014 |
NPI Last Update Date: | 10/17/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LN0000X |
License Number: | ARNP9311068 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Neonatal |
Taxonomy Definition: |