Provider Demographics
NPI:1609581826
Name:RAINER, NUYNA
Entity Type:Individual
Prefix:
First Name:NUYNA
Middle Name:
Last Name:RAINER
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 1:4712 FLAT SHOALS RD APT 5107
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:GA
Mailing Address - Zip Code:30291-1682
Mailing Address - Country:US
Mailing Address - Phone:678-751-8360
Mailing Address - Fax:
Practice Address - Street 1:4712 FLAT SHOALS RD APT 5107
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:GA
Practice Address - Zip Code:30291-1682
Practice Address - Country:US
Practice Address - Phone:678-751-8360
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-23
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA221363311744P3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case Management