Provider Demographics
NPI:1326536129
Name:RAILEAN, ANASTASIA
Entity Type:Individual
Prefix:
First Name:ANASTASIA
Middle Name:
Last Name:RAILEAN
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 1:7348 THALIA WAY
Mailing Address - Street 2:
Mailing Address - City:CITRUS HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:95621-5595
Mailing Address - Country:US
Mailing Address - Phone:916-749-9009
Mailing Address - Fax:
Practice Address - Street 1:WAKE FOREST BAPTIST MEDICAL CENTER MEDICAL CENTER BLVD
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27157-2153
Practice Address - Country:US
Practice Address - Phone:336-716-2694
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-26
Last Update Date:2019-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program