Provider Demographics
NPI:1841578598
Name:RAYBON, DEENA JO (RN)
Entity Type:Individual
Prefix:MRS
First Name:DEENA
Middle Name:JO
Last Name:RAYBON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2811 CALDERA BLVD
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79705-2609
Mailing Address - Country:US
Mailing Address - Phone:432-681-7613
Mailing Address - Fax:432-699-6290
Practice Address - Street 1:2811 CALDERA BLVD
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79705-2609
Practice Address - Country:US
Practice Address - Phone:432-681-7613
Practice Address - Fax:432-699-6290
Is Sole Proprietor?:No
Enumeration Date:2011-07-29
Last Update Date:2011-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX557400163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse