Provider Demographics
NPI:1134547060
Name:RAINEY, ANTOINETTE DENISE (MD)
Entity type:Individual
Prefix:
First Name:ANTOINETTE
Middle Name:DENISE
Last Name:RAINEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2040 W CHARLESTON BLVD
Mailing Address - Street 2:UNSOM INTERNAL MEDICINE
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-2227
Mailing Address - Country:US
Mailing Address - Phone:702-671-2341
Mailing Address - Fax:
Practice Address - Street 1:2040 W CHARLESTON BLVD
Practice Address - Street 2:UNSOM INTERNAL MEDICINE
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-2227
Practice Address - Country:US
Practice Address - Phone:702-671-2341
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-28
Last Update Date:2014-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program