Individual
JAMIE B RAISOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
1075 LAFAYETTE PKWY STE 240, LAGRANGE, GA 30241-3734
(770) 400-8400
Mailing address
PO BOX 23329, NEW YORK, NY 10087-3329
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN-NP145004
GA
363LF0000X
Family Nurse Practitioner
AP127054
TX
363LF0000X
Family Nurse Practitioner
Primary
RN145004
GA
Other
Enumeration date
07/08/2008
Last updated
05/15/2026
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