Provider Demographics
NPI:1255957007
Name:RAYMOND, KATHRYN (FNP-C)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:RAYMOND
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 1:112 FULLER RD
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:ME
Mailing Address - Zip Code:04740-4123
Mailing Address - Country:US
Mailing Address - Phone:207-551-6799
Mailing Address - Fax:
Practice Address - Street 1:23 NORTH ST
Practice Address - Street 2:
Practice Address - City:PRESQUE ISLE
Practice Address - State:ME
Practice Address - Zip Code:04769-2291
Practice Address - Country:US
Practice Address - Phone:207-764-3142
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-17
Last Update Date:2020-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECNP201197363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care