Provider Demographics
NPI:1902482557
Name:RAGGIO, LAYNE (PA-C)
Entity Type:Individual
Prefix:
First Name:LAYNE
Middle Name:
Last Name:RAGGIO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6901 GENERAL HAIG ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70124-4030
Mailing Address - Country:US
Mailing Address - Phone:985-630-5149
Mailing Address - Fax:
Practice Address - Street 1:2450 SEVERN AVE STE 510
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70001-6953
Practice Address - Country:US
Practice Address - Phone:985-630-5149
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-23
Last Update Date:2021-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA324460363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical