Provider Demographics
NPI:1942050372
Name:RAINES, KATHY S (CD, ICCE)
Entity Type:Individual
Prefix:
First Name:KATHY
Middle Name:S
Last Name:RAINES
Suffix:
Gender:F
Credentials:CD, ICCE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 ARGYLL CIR
Mailing Address - Street 2:
Mailing Address - City:BELLA VISTA
Mailing Address - State:AR
Mailing Address - Zip Code:72715-2906
Mailing Address - Country:US
Mailing Address - Phone:479-936-6780
Mailing Address - Fax:
Practice Address - Street 1:14 ARGYLL CIR
Practice Address - Street 2:
Practice Address - City:BELLA VISTA
Practice Address - State:AR
Practice Address - Zip Code:72715-2906
Practice Address - Country:US
Practice Address - Phone:479-936-6780
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-26
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula