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General NPI Number Information
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NPI Number | 1245754738
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Entity Type | Individual
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Provider Name | RAEANN RAISOR
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Gender | Female
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Dates
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Enumeration Date | 07/27/2017
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Last Update Date | 04/07/2025
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Provider Practice Location Address
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Address Line | 2355 W 136TH AVE
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City | BROOMFIELD
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State | CO
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Zip | 80023-9331
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Country | US
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Telephone | 303-658-9827
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Fax | 303-658-9828
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Provider Business Mailing Address
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Address Line | 2355 W 136TH AVE
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City | BROOMFIELD
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State | CO
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Zip | 80023-9331
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Country | US
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Telephone | 941-650-9363
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Fax | 36-589-8283
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RXN0101204
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN11010306
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 0101204
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License Number State | CO
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APN.0101839-NP
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License Number State | CO
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