Provider Demographics
NPI:1023052206
Name:RAINEY, LETITIA C (APN)
Entity type:Individual
Prefix:
First Name:LETITIA
Middle Name:C
Last Name:RAINEY
Suffix:
Gender:F
Credentials:APN
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 24730
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37202-4730
Mailing Address - Country:US
Mailing Address - Phone:615-386-2300
Mailing Address - Fax:615-386-2399
Practice Address - Street 1:5201 CHARLOTTE AVE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37209
Practice Address - Country:US
Practice Address - Phone:615-222-1900
Practice Address - Fax:615-222-1917
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2010-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4141489OtherBLUE CROSS
TN3660848Medicaid
3660848Medicare PIN
TN4141489OtherBLUE CROSS