Provider Demographics
NPI:1588236939
Name:JESSICA RAYMOND, NURSE PRACTITIONER IN PSYCHIATRY, PLLC
Entity Type:Organization
Organization Name:JESSICA RAYMOND, NURSE PRACTITIONER IN PSYCHIATRY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:RAYMOND
Authorized Official - Suffix:
Authorized Official - Credentials:NPP
Authorized Official - Phone:607-222-1292
Mailing Address - Street 1:9 VALLEY VIEW CT
Mailing Address - Street 2:
Mailing Address - City:BINGHAMTON
Mailing Address - State:NY
Mailing Address - Zip Code:13904-2814
Mailing Address - Country:US
Mailing Address - Phone:607-222-1292
Mailing Address - Fax:
Practice Address - Street 1:76 BROAD AVE # 1
Practice Address - Street 2:
Practice Address - City:BINGHAMTON
Practice Address - State:NY
Practice Address - Zip Code:13904-1406
Practice Address - Country:US
Practice Address - Phone:607-217-7183
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-14
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health