Provider Demographics
NPI:1801195805
Name:RAYMOND, MARIE LYNNE
Entity Type:Individual
Prefix:
First Name:MARIE LYNNE
Middle Name:
Last Name:RAYMOND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 SOUTHERN CROSS LN
Mailing Address - Street 2:204
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33436-6774
Mailing Address - Country:US
Mailing Address - Phone:561-856-1605
Mailing Address - Fax:
Practice Address - Street 1:7 SOUTHERN CROSS LN
Practice Address - Street 2:204
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33436-6774
Practice Address - Country:US
Practice Address - Phone:561-856-1605
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-16
Last Update Date:2011-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No372600000XNursing Service Related ProvidersAdult Companion