Healthcare Provider Details

I. General information

NPI: 1083764237
Provider Name (Legal Business Name): KATHRYN YVONNE RAYMOND M.S., A.P.R.N., B.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/11/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

305 BELMONT ST
WORCESTER MA
01604-1681
US

IV. Provider business mailing address

512 MASSASOIT RD
WORCESTER MA
01604-3548
US

V. Phone/Fax

Practice location:
  • Phone: 508-368-3300
  • Fax: 508-363-1516
Mailing address:
  • Phone: 508-757-8183
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License Number151213
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: