Provider Demographics
NPI:1437193687
Name:RAYNER, JULIE SWEET (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:SWEET
Last Name:RAYNER
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 601549
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-1549
Mailing Address - Country:US
Mailing Address - Phone:704-316-1594
Mailing Address - Fax:704-316-9771
Practice Address - Street 1:200 HAWTHORNE LANE
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28204-2515
Practice Address - Country:US
Practice Address - Phone:704-384-4274
Practice Address - Fax:704-384-5636
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2008-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC083472367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCNAN421Medicaid
NC8052029Medicaid
NC805202AMedicaid
NC2627551CMedicare PIN
NC805202AMedicaid
SCNAN421Medicaid