Provider Demographics
NPI:1659021467
Name:RAINIER, CASSI NICCOLE
Entity Type:Individual
Prefix:
First Name:CASSI
Middle Name:NICCOLE
Last Name:RAINIER
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 1:1781 COUNTRYSIDE DR
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:OH
Mailing Address - Zip Code:43130-1186
Mailing Address - Country:US
Mailing Address - Phone:740-687-8600
Mailing Address - Fax:
Practice Address - Street 1:1781 COUNTRYSIDE DR
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130-1186
Practice Address - Country:US
Practice Address - Phone:740-687-8600
Practice Address - Fax:740-475-0598
Is Sole Proprietor?:No
Enumeration Date:2022-03-25
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.400759363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily