Provider Demographics
NPI:1275287336
Name:ROCKWELL, RAINA LEE (BSN, RN)
Entity Type:Individual
Prefix:MRS
First Name:RAINA
Middle Name:LEE
Last Name:ROCKWELL
Suffix:
Gender:F
Credentials:BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:148 T AND H DR
Mailing Address - Street 2:
Mailing Address - City:PICKENS
Mailing Address - State:SC
Mailing Address - Zip Code:29671-9358
Mailing Address - Country:US
Mailing Address - Phone:864-517-7701
Mailing Address - Fax:
Practice Address - Street 1:900 WOODSIDE AVE
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29611-4221
Practice Address - Country:US
Practice Address - Phone:864-565-8004
Practice Address - Fax:864-383-6293
Is Sole Proprietor?:No
Enumeration Date:2022-02-08
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC250769163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool