Provider Demographics
NPI:1881244713
Name:RAYMOND, EMELINE (CNA)
Entity type:Individual
Prefix:MS
First Name:EMELINE
Middle Name:
Last Name:RAYMOND
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 WEDGEWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:GREENACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33463-3078
Mailing Address - Country:US
Mailing Address - Phone:732-735-9303
Mailing Address - Fax:561-766-2525
Practice Address - Street 1:215 WEDGEWOOD CIR
Practice Address - Street 2:
Practice Address - City:GREENACRES
Practice Address - State:FL
Practice Address - Zip Code:33463-3078
Practice Address - Country:US
Practice Address - Phone:732-735-9303
Practice Address - Fax:561-766-2525
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-12
Last Update Date:2019-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL182073376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide