Provider Demographics
NPI:1134869092
Name:RAINONE, CAROLINE CHRISTINA
Entity type:Individual
Prefix:
First Name:CAROLINE
Middle Name:CHRISTINA
Last Name:RAINONE
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 1:69A KIMBALL DR
Mailing Address - Street 2:
Mailing Address - City:HOOKSETT
Mailing Address - State:NH
Mailing Address - Zip Code:03106-2617
Mailing Address - Country:US
Mailing Address - Phone:860-436-8521
Mailing Address - Fax:
Practice Address - Street 1:155 HAZARD AVE STE 2
Practice Address - Street 2:
Practice Address - City:ENFIELD
Practice Address - State:CT
Practice Address - Zip Code:06082-4586
Practice Address - Country:US
Practice Address - Phone:860-698-6041
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-30
Last Update Date:2022-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT010097363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner