Provider Demographics
NPI:1518685478
Name:RAYNER, MARIONNE (NP)
Entity Type:Individual
Prefix:
First Name:MARIONNE
Middle Name:
Last Name:RAYNER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20214 ANDORRA POINTE TRCE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-2330
Mailing Address - Country:US
Mailing Address - Phone:832-403-0352
Mailing Address - Fax:
Practice Address - Street 1:211 HIGHLAND CROSS DR STE 105
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77073-1700
Practice Address - Country:US
Practice Address - Phone:713-422-2920
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-17
Last Update Date:2022-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP145109363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily