Provider Demographics
NPI:1740705292
Name:RAINEY, PRINCE PAUL (CNA, CPC, CPAR)
Entity type:Individual
Prefix:MR
First Name:PRINCE
Middle Name:PAUL
Last Name:RAINEY
Suffix:
Gender:M
Credentials:CNA, CPC, CPAR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 DOUG BAKER BLVD
Mailing Address - Street 2:STE 107 486
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242-4974
Mailing Address - Country:US
Mailing Address - Phone:205-374-8324
Mailing Address - Fax:205-922-5422
Practice Address - Street 1:1401 DOUG BAKER BLVD STE 107486
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35242-4974
Practice Address - Country:US
Practice Address - Phone:205-374-8324
Practice Address - Fax:205-922-5422
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-06
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X, 253Z00000X
AL374U00000X, 376J00000X, 376K00000X, 385H00000X, 3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive CareGroup - Single Specialty
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty
No376J00000XNursing Service Related ProvidersHomemaker
No376K00000XNursing Service Related ProvidersNurse's Aide
No385H00000XRespite Care FacilityRespite CareGroup - Single Specialty