Healthcare Provider Details

I. General information

NPI: 1932536356
Provider Name (Legal Business Name): HOPE G RAGGS ANP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2013
Last Update Date: 03/26/2020
Certification Date: 03/26/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 S MANNING BLVD
ALBANY NY
12208-1707
US

IV. Provider business mailing address

PO BOX 6084
ALBANY NY
12206-0084
US

V. Phone/Fax

Practice location:
  • Phone: 518-525-1550
  • Fax:
Mailing address:
  • Phone: 518-577-7612
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number306676
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: