Provider Demographics
NPI:1669247417
Name:RAYNER, DONISHA SHONTA (CNA)
Entity type:Individual
Prefix:
First Name:DONISHA
Middle Name:SHONTA
Last Name:RAYNER
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 JEAN DR
Mailing Address - Street 2:
Mailing Address - City:FLORISSANT
Mailing Address - State:MO
Mailing Address - Zip Code:63031-8417
Mailing Address - Country:US
Mailing Address - Phone:314-914-4904
Mailing Address - Fax:
Practice Address - Street 1:11 JEAN DR
Practice Address - Street 2:
Practice Address - City:FLORISSANT
Practice Address - State:MO
Practice Address - Zip Code:63031-8417
Practice Address - Country:US
Practice Address - Phone:314-914-4904
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-21
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide