Provider Demographics
NPI:1881190916
Name:BEHM, RAISSA M (APRN)
Entity Type:Individual
Prefix:
First Name:RAISSA
Middle Name:M
Last Name:BEHM
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18606 WHITE RIM TRL
Mailing Address - Street 2:
Mailing Address - City:JONESTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78645-2955
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1201 N LAKELINE BLVD STE 400
Practice Address - Street 2:
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613
Practice Address - Country:US
Practice Address - Phone:512-379-7272
Practice Address - Fax:512-379-7271
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-05
Last Update Date:2018-07-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXAP137903363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily