Provider Demographics
NPI:1649946104
Name:RAINEY, MONTOYA RENEE (APRN-CNP)
Entity type:Individual
Prefix:
First Name:MONTOYA
Middle Name:RENEE
Last Name:RAINEY
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3201 GEORGE BUSH HWY STE 107
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75082-3565
Mailing Address - Country:US
Mailing Address - Phone:972-276-9902
Mailing Address - Fax:
Practice Address - Street 1:3201 GEORGE BUSH HWY STE 107
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75082-3565
Practice Address - Country:US
Practice Address - Phone:972-276-9902
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-16
Last Update Date:2021-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1050552363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1050552OtherTX BON