Provider Demographics
NPI:1689093973
Name:RAINEY, CATHERINE
Entity Type:Individual
Prefix:MISS
First Name:CATHERINE
Middle Name:
Last Name:RAINEY
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 1:209 N BEECH AVE
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23075-1409
Mailing Address - Country:US
Mailing Address - Phone:804-737-3802
Mailing Address - Fax:276-209-3043
Practice Address - Street 1:209 N BEECH AVE
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23075-1409
Practice Address - Country:US
Practice Address - Phone:804-737-3802
Practice Address - Fax:276-209-3043
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-15
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization