Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Raven Angelic Tate

Individual provider Registered Nurse · NPI 1043132251

Raven Angelic Tate is a Registered Nurse in Glendale, Arizona. Practices as a sole proprietor. Licensed in Arizona.

Licensed in
AZ
In the registry since
2026

Practice location Address checks out

15421 N 63rd Ave
Glendale, AZ 85306-2910
Phone: (623) 703-5214
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Registered Nurse (primary) Taxonomy 163W00000X · Licence 261425 (AZ)

Record details

NPI number1043132251
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedJuly 28, 2026
Last updated in NPPESJuly 28, 2026
Certification dateJuly 28, 2026

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