Provider Demographics
NPI:1356618094
Name:RAINEY, PATRICIA (PNP)
Entity type:Individual
Prefix:MR
First Name:PATRICIA
Middle Name:
Last Name:RAINEY
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 OLD MILTON PKWY # A
Mailing Address - Street 2:SUITE 330
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30005-3707
Mailing Address - Country:US
Mailing Address - Phone:770-751-6111
Mailing Address - Fax:770-772-6099
Practice Address - Street 1:3400 OLD MILTON PKWY # A
Practice Address - Street 2:SUITE 330
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30005-3707
Practice Address - Country:US
Practice Address - Phone:770-751-6111
Practice Address - Fax:770-772-6099
Is Sole Proprietor?:No
Enumeration Date:2011-11-23
Last Update Date:2011-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN112656363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner