Provider Demographics
NPI:1780498493
Name:RAYMOND, JESSICA LEIGH (CMA)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:LEIGH
Last Name:RAYMOND
Suffix:
Gender:F
Credentials:CMA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2145 GRANT ST
Mailing Address - Street 2:
Mailing Address - City:BLAIR
Mailing Address - State:NE
Mailing Address - Zip Code:68008-1825
Mailing Address - Country:US
Mailing Address - Phone:402-594-4840
Mailing Address - Fax:
Practice Address - Street 1:1055 N 115TH ST STE 202
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68154-4419
Practice Address - Country:US
Practice Address - Phone:402-359-1265
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-04
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide