Provider Demographics
NPI:1245619816
Name:ALLEE-MANNING, RAYNA
Entity Type:Individual
Prefix:
First Name:RAYNA
Middle Name:
Last Name:ALLEE-MANNING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1110 E 136TH ST
Mailing Address - Street 2:
Mailing Address - City:GRANDVIEW
Mailing Address - State:MO
Mailing Address - Zip Code:64030-3633
Mailing Address - Country:US
Mailing Address - Phone:816-442-4776
Mailing Address - Fax:
Practice Address - Street 1:1010 REMINGTON PLZ
Practice Address - Street 2:
Practice Address - City:RAYMORE
Practice Address - State:MO
Practice Address - Zip Code:64083-8640
Practice Address - Country:US
Practice Address - Phone:816-318-4430
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-28
Last Update Date:2015-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2007021956164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse