Provider Demographics
NPI:1861444507
Name:RAYMOND, LAURIE A (NP)
Entity type:Individual
Prefix:
First Name:LAURIE
Middle Name:A
Last Name:RAYMOND
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 DAVIS RD
Mailing Address - Street 2:
Mailing Address - City:FALMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02540-2812
Mailing Address - Country:US
Mailing Address - Phone:508-495-0384
Mailing Address - Fax:
Practice Address - Street 1:200A JONES RD.
Practice Address - Street 2:
Practice Address - City:FALMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02540
Practice Address - Country:US
Practice Address - Phone:508-540-0900
Practice Address - Fax:508-548-6358
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2009-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA228615163WX0601X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WX0601XNursing Service ProvidersRegistered NurseOtorhinolaryngology & Head-Neck
Provider Identifiers
StateIdentifier IDID TypeIssuer
NP2817Medicare ID - Type Unspecified