Provider Demographics
NPI:1831742659
Name:RAINEY, RACHEL MARIE (MSN, APRN, FNP)
Entity type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:MARIE
Last Name:RAINEY
Suffix:
Gender:F
Credentials:MSN, APRN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3221 MCKELVEY RD STE 301
Mailing Address - Street 2:
Mailing Address - City:BRIDGETON
Mailing Address - State:MO
Mailing Address - Zip Code:63044-2551
Mailing Address - Country:US
Mailing Address - Phone:636-498-5973
Mailing Address - Fax:
Practice Address - Street 1:1598 W MEYER RD
Practice Address - Street 2:
Practice Address - City:WENTZVILLE
Practice Address - State:MO
Practice Address - Zip Code:63385-3653
Practice Address - Country:US
Practice Address - Phone:636-332-8228
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-21
Last Update Date:2019-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOF07191407363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily