Dr RAVEN B CUSTALOW is a female medical professional, specializing in Nurse Practitioner. She graduated in 2018.
RIVERSIDE PHYSICIAN SERVICES INC
17452 RICHMOND RD
CALLAO
VA
224352420
Tel: 8045296141
| Npi | 1669955019 |
| Pac Id | 0840543013 |
| Professional Enrollment Id | I20181106000339 |
| Last Name | CUSTALOW |
| First Name | RAVEN |
| Middle Name | B |
| Suffix | |
| Gender | F |
| Credential | |
| Medical School Name | OTHER |
| Graduation Year | 2018 |
| Primary Specialty | NURSE PRACTITIONER |
| Secondary Specialty 1 | |
| Secondary Specialty 2 | |
| Secondary Specialty 3 | |
| Secondary Specialty 4 | |
| All Secondary Specialties | |
| Organization Legal Name | RIVERSIDE PHYSICIAN SERVICES INC |
| Group Practice Pac Id | 5092608448 |
| Number Of Group Practice Members | 527 |
| Line 1 Street Address | 17452 RICHMOND RD |
| Line 2 Street Address | |
| Marker Of Address Line 2 Suppression | |
| City | CALLAO |
| State | VA |
| Zip Code | 224352420 |
| Phone Number | 8045296141 |
| Hospital Affiliation Ccn 1 | 490084 |
| Hospital Affiliation Lbn 1 | RIVERSIDE TAPPAHANNOCK HOSPITAL |
| Hospital Affiliation Ccn 2 | 491308 |
| Hospital Affiliation Lbn 2 | RAPPAHANNOCK GENERAL HOSPITAL |
| Hospital Affiliation Ccn 3 | |
| Hospital Affiliation Lbn 3 | |
| Hospital Affiliation Ccn 4 | |
| Hospital Affiliation Lbn 4 | |
| Hospital Affiliation Ccn 5 | |
| Hospital Affiliation Lbn 5 | |
| Professional Accepts Medicare Assignment | Y |
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