Provider Demographics
NPI:1023260452
Name:MILLER, RAINI L (BSN, RN-BC, CSAC)
Entity type:Individual
Prefix:MRS
First Name:RAINI
Middle Name:L
Last Name:MILLER
Suffix:
Gender:F
Credentials:BSN, RN-BC, CSAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:459 PATTERSON ROAD VA PACIFIC ISLANDS HEALTH CARE SYSTE
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96819-1522
Mailing Address - Country:US
Mailing Address - Phone:808-538-2518
Mailing Address - Fax:808-839-1747
Practice Address - Street 1:459 PATTERSON ROAD VA PACIFIC ISLANDS HEALTH CARE SYSTE
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96819-1522
Practice Address - Country:US
Practice Address - Phone:808-538-2518
Practice Address - Fax:808-839-1747
Is Sole Proprietor?:No
Enumeration Date:2008-10-16
Last Update Date:2018-08-29
Deactivation Date:2012-02-16
Deactivation Code:
Reactivation Date:2018-08-29
Provider Licenses
StateLicense IDTaxonomies
HI47601163WA0400X, 163WC0400X, 163WP0809X, 163WP0807X
CA552162163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & Adolescent
No163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)
No163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical
No163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult