Provider Demographics
NPI:1427929207
Name:RAWLEY, NOVA (RN)
Entity type:Individual
Prefix:
First Name:NOVA
Middle Name:
Last Name:RAWLEY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2934 HIGHWAY 93 N
Mailing Address - Street 2:
Mailing Address - City:GIBBSONVILLE
Mailing Address - State:ID
Mailing Address - Zip Code:83463-8501
Mailing Address - Country:US
Mailing Address - Phone:512-923-5105
Mailing Address - Fax:
Practice Address - Street 1:2934 HIGHWAY 93 N
Practice Address - Street 2:
Practice Address - City:GIBBSONVILLE
Practice Address - State:ID
Practice Address - Zip Code:83463-8501
Practice Address - Country:US
Practice Address - Phone:512-923-5105
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-15
Last Update Date:2025-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID64096163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice