Provider Demographics
NPI:1164703336
Name:RAYMOND, LINDSEY GAYLE (CNP)
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:GAYLE
Last Name:RAYMOND
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2201 JACKSON BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57702-4339
Mailing Address - Country:US
Mailing Address - Phone:202-258-1844
Mailing Address - Fax:918-721-0309
Practice Address - Street 1:2201 JACKSON BLVD STE 100
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57702-4339
Practice Address - Country:US
Practice Address - Phone:202-258-1844
Practice Address - Fax:918-721-0309
Is Sole Proprietor?:No
Enumeration Date:2011-09-01
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDCP002346363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily