Provider Demographics
NPI:1255831541
Name:RAYNOW, ANNAMARIE (LPN)
Entity Type:Individual
Prefix:MS
First Name:ANNAMARIE
Middle Name:
Last Name:RAYNOW
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3672 KENT RD APT 50OHIO
Mailing Address - Street 2:
Mailing Address - City:STOW
Mailing Address - State:OH
Mailing Address - Zip Code:44224-4628
Mailing Address - Country:US
Mailing Address - Phone:216-346-9718
Mailing Address - Fax:216-346-9718
Practice Address - Street 1:3672 KENT RD APT 50OHIO
Practice Address - Street 2:
Practice Address - City:STOW
Practice Address - State:OH
Practice Address - Zip Code:44224-4628
Practice Address - Country:US
Practice Address - Phone:216-346-9718
Practice Address - Fax:216-346-9718
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-13
Last Update Date:2018-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH162477164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Single Specialty