Provider Demographics
NPI:1750753117
Name:RAINEY, CAROLINE PHILLIPS (CPNP)
Entity type:Individual
Prefix:MRS
First Name:CAROLINE
Middle Name:PHILLIPS
Last Name:RAINEY
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 25TH AVE N STE 210
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-1515
Mailing Address - Country:US
Mailing Address - Phone:334-797-7538
Mailing Address - Fax:
Practice Address - Street 1:16 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:MONROEVILLE
Practice Address - State:AL
Practice Address - Zip Code:36460-3036
Practice Address - Country:US
Practice Address - Phone:251-575-3266
Practice Address - Fax:251-575-3262
Is Sole Proprietor?:No
Enumeration Date:2015-10-26
Last Update Date:2018-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN20603363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics