Healthcare Provider Details

I. General information

NPI: 1699812396
Provider Name (Legal Business Name): REBECCA ANN RAYMOND RN,APN,C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MS. REBECCA ANN CASSADAY

II. Dates (important events)

Enumeration Date: 01/31/2007
Last Update Date: 10/18/2024
Certification Date: 10/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 ENGLISH CREEK AVE BLDG 400
EGG HARBOR TOWNSHIP NJ
08234
US

IV. Provider business mailing address

108 OFFSHORE ROAD
EGG HARBOR TOWNSHIP NJ
08234-8113
US

V. Phone/Fax

Practice location:
  • Phone: 609-677-7700
  • Fax:
Mailing address:
  • Phone: 609-441-8146
  • Fax: 609-441-8002

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number26NJ00044300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: