Provider Demographics
NPI:1417782350
Name:RAYMOND, NADEGE (RN, OWNER, DIRECTOR)
Entity type:Individual
Prefix:
First Name:NADEGE
Middle Name:
Last Name:RAYMOND
Suffix:
Gender:F
Credentials:RN, OWNER, DIRECTOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5300 MEMORIAL DR STE 123G
Mailing Address - Street 2:
Mailing Address - City:STONE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30083-3155
Mailing Address - Country:US
Mailing Address - Phone:470-615-0534
Mailing Address - Fax:
Practice Address - Street 1:5300 MEMORIAL DR STE 123G
Practice Address - Street 2:
Practice Address - City:STONE MOUNTAIN
Practice Address - State:GA
Practice Address - Zip Code:30083-3155
Practice Address - Country:US
Practice Address - Phone:470-615-0534
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-02
Last Update Date:2024-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN193481163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse