Raven Custalow, AGPCNP-BC
Raven Custalow, AGPCNP-BC is a Nurse Practitioner in Aylett, Virginia. Graduated from Georgetown University School of Medicine in 2018, 8 years ago. Practices with Upper Mattaponi Indian Tribe, a 5-clinician group and accepts Medicare assignment. Licensed in Virginia.
- Years since qualifying
- 8
- Trained at
- Georgetown University School of Medicine
- Licensed in
- VA
- In the registry since
- 2018
Practice location Address checks out
7864 Richmond Tappahannock HwyAylett, VA 23009-3056
Phone: (804) 769-2015
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Primary Care Nurse Practitioner (primary) | Taxonomy 363LP2300X · Licence 0024176579 (VA) |
|---|
Record details
| NPI number | 1669955019 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Credentials | AGPCNP-BC |
| Sole proprietor | No |
| NPI enumerated | September 12, 2018 |
| Last updated in NPPES | November 8, 2024 |
| Certification date | November 8, 2024 |
Medicare enrollment
| Medicare specialty | NURSE PRACTITIONER |
|---|---|
| Medical school | GEORGETOWN UNIVERSITY SCHOOL OF MEDICINE |
| Graduated | 2018 (8 years in practice) |
| Group practice | Upper Mattaponi Indian Tribe — 5 clinicians |
| Accepts Medicare assignment | Yes — accepts the Medicare-approved amount |
Other providers in Aylett
-
Andrea Garrett, NP
4917 Richmond Tappahannock Hwy Ste 1B, Aylett, VA 23009-3416 · (804) 769-1245
-
Latonia J McSwain, FNP-C
11814 King William Rd, Aylett, VA 23009-4103 · (804) 769-4499