Provider Demographics
NPI:1205854338
Name:RAINES, AMY HOLBERT (CRNP)
Entity Type:Individual
Prefix:MS
First Name:AMY
Middle Name:HOLBERT
Last Name:RAINES
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3421 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9001
Mailing Address - Country:US
Mailing Address - Phone:717-851-4005
Mailing Address - Fax:717-812-2495
Practice Address - Street 1:605 S GEORGE ST
Practice Address - Street 2:STE 200
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17401-3160
Practice Address - Country:US
Practice Address - Phone:717-851-2334
Practice Address - Fax:717-851-3498
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2015-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAUP001654B363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA105127OtherJOHNS HOPKINS
PA50080296OtherCAPITAL BLUE CROSS-YH (IM)
PA20019458OtherAMERIHEALTH MERCY-WMG
PA03006501OtherCAPITAL BLUE CROSS-WMG
PA1551671OtherGATEWAY-WMG
PA1933968OtherHIGHMARK BLUE SHIELD
MD542985OtherCAREFIRST MD BCBS
PA500028951Medicare PIN
PA1933968OtherHIGHMARK BLUE SHIELD
S47320Medicare UPIN
MD542985OtherCAREFIRST MD BCBS
PA50080296OtherCAPITAL BLUE CROSS-YH (IM)