Provider Demographics
NPI:1093016081
Name:RAINEY, AMIE SIMS (NP-C)
Entity Type:Individual
Prefix:
First Name:AMIE
Middle Name:SIMS
Last Name:RAINEY
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 349
Mailing Address - Street 2:3062 MAIN STREET
Mailing Address - City:PIKEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37367-0349
Mailing Address - Country:US
Mailing Address - Phone:423-447-2955
Mailing Address - Fax:423-447-2405
Practice Address - Street 1:3062 MAIN ST
Practice Address - Street 2:
Practice Address - City:PIKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:37367-5746
Practice Address - Country:US
Practice Address - Phone:423-447-2955
Practice Address - Fax:423-447-2405
Is Sole Proprietor?:No
Enumeration Date:2010-11-08
Last Update Date:2017-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN0000103481363LF0000X
TNAPN0000015214363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily