Raven Hathaway, FNP-BC
NPI #1285519850 in Johnson City, New York
Provider Information
- NPI Number
- 1285519850
- Entity Type
- Individual
- Name
- Raven Hathaway, FNP-BC
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Nurse Practitioner - Family
- Credential
- FNP-BC
- Enumeration Date
- Aug 11, 2025
- Last Updated
- Aug 11, 2025
Practice Location
- Address
- 30 HARRISON ST
- City
- Johnson City
- State
- New York
- ZIP Code
- 13790-2161
- Phone
- (607) 763-0088
Specialties & Taxonomy Codes
| Specialty |
|---|
| Nurse Practitioner - Family — Family |
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