Healthcare Provider Details

I. General information

NPI: 1245168426
Provider Name (Legal Business Name): KIM ANN RAYMOND
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5353 REYNOLDS ST
SAVANNAH GA
31405-6015
US

IV. Provider business mailing address

214 FLINT CREEK DR
RICHMOND HILL GA
31324-3715
US

V. Phone/Fax

Practice location:
  • Phone: 912-819-6295
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License NumberRN276092
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: