Individual
MRS. JACKIE RAYMOND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
225 NEW LANCASTER RD, LEOMINSTER, MA 01453-4958
(978) 466-3208
(978) 840-1680
Mailing address
225 NEW LANCASTER RD, LEOMINSTER, MA 01453-4958
(978) 466-3208
(978) 840-1680
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN2289192
MA
363LF0000X
Family Nurse Practitioner
Primary
RN2289192
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110110032A
—
MA
Enumeration date
12/06/2013
Last updated
08/10/2021
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