Healthcare Provider Details

I. General information

NPI: 1023665619
Provider Name (Legal Business Name): KATRINA RAAF P.A.-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2019
Last Update Date: 09/09/2025
Certification Date: 09/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6438 WILMINGTON PIKE, ST 110
CENTERVILLE OH
45459
US

IV. Provider business mailing address

6438 WILMINGTON PIKE STE 110
DAYTON OH
45459-7021
US

V. Phone/Fax

Practice location:
  • Phone: 937-848-4121
  • Fax: 937-848-5965
Mailing address:
  • Phone: 937-848-4121
  • Fax: 937-848-5965

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number50.006085RX
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: