Provider Demographics
NPI:1811217979
Name:RAINBOLT, JOYCE K
Entity Type:Individual
Prefix:MS
First Name:JOYCE
Middle Name:K
Last Name:RAINBOLT
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:PO BOX 2585
Mailing Address - Street 2:
Mailing Address - City:MILLS
Mailing Address - State:WY
Mailing Address - Zip Code:82644-2585
Mailing Address - Country:US
Mailing Address - Phone:307-266-3070
Mailing Address - Fax:307-235-2109
Practice Address - Street 1:520 S WALNUT ST
Practice Address - Street 2:
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82601-2313
Practice Address - Country:US
Practice Address - Phone:307-266-3070
Practice Address - Fax:307-235-2109
Is Sole Proprietor?:No
Enumeration Date:2010-06-10
Last Update Date:2010-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator