Provider Demographics
NPI:1346826518
Name:GAINES, ANITA LEE
Entity Type:Individual
Prefix:MS
First Name:ANITA
Middle Name:LEE
Last Name:GAINES
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 1:8715 MOONLIGHT DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45231-4115
Mailing Address - Country:US
Mailing Address - Phone:513-462-0549
Mailing Address - Fax:
Practice Address - Street 1:8715 MOONLIGHT DR
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45231-4115
Practice Address - Country:US
Practice Address - Phone:513-729-1599
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-19
Last Update Date:2021-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide