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NPI Code Detail

MEDICARE: MS. MARY ELAINE RAINES

MEDICARE: MS. MARY ELAINE RAINES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1093883035
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MARY ELAINE RAINES
Provider Business Mailing Address
First Line : 311 WHITTINGTON AVE
Second Line :
City : HOT SPRINGS
State : AR
Zip : 71901-3407
Country : US
Telephone Number : 501-623-3477
Fax Number : 501-623-3477
Provider Business Practice Location Address
First Line : 311 WHITTINGTON AVE
Second Line :
City : HOT SPRINGS
State : AR
Zip : 71901-3407
Country : US
Telephone Number : 501-623-3477
Fax Number : 501-623-3477
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/30/2006
Last Update Date : 08/19/2011

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