Provider Demographics
NPI:1053831750
Name:RAYMER, CHRISTIN HEVERLY (FNP-C)
Entity Type:Individual
Prefix:
First Name:CHRISTIN
Middle Name:HEVERLY
Last Name:RAYMER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:328 CARTHAGE CT
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27703-7730
Mailing Address - Country:US
Mailing Address - Phone:919-451-0563
Mailing Address - Fax:
Practice Address - Street 1:110 BOONE SQUARE ST STE 29A
Practice Address - Street 2:
Practice Address - City:HILLSBOROUGH
Practice Address - State:NC
Practice Address - Zip Code:27278-2665
Practice Address - Country:US
Practice Address - Phone:919-245-1213
Practice Address - Fax:855-604-6244
Is Sole Proprietor?:No
Enumeration Date:2017-06-23
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5009591207Q00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1053831750Medicaid