Provider Demographics
NPI:1396062618
Name:GAINEY, MISTY DAWN (RN BSN SRNA)
Entity type:Individual
Prefix:MS
First Name:MISTY
Middle Name:DAWN
Last Name:GAINEY
Suffix:
Gender:F
Credentials:RN BSN SRNA
Other - Prefix:MS
Other - First Name:MISTY
Other - Middle Name:
Other - Last Name:BENFIELD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA, MSN, BSN, RN
Mailing Address - Street 1:5213 S ALSTON AVE
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-4430
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2301 ERWIN RD
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-4699
Practice Address - Country:US
Practice Address - Phone:919-684-8111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-26
Last Update Date:2015-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC201456163W00000X
NC084704367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse