Provider Demographics
NPI:1750411245
Name:GIVENS, RAVII MIKEL
Entity type:Individual
Prefix:MR
First Name:RAVII
Middle Name:MIKEL
Last Name:GIVENS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1106 EAGER DR
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31707-3858
Mailing Address - Country:US
Mailing Address - Phone:229-434-9373
Mailing Address - Fax:
Practice Address - Street 1:1106 EAGER DR
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31707-3858
Practice Address - Country:US
Practice Address - Phone:229-434-9373
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide