Healthcare Provider Details

I. General information

NPI: 1235309436
Provider Name (Legal Business Name): KEITH ANDREW RAINS RN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/04/2008
Last Update Date: 03/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1055 CLERMONT ST # 111L
DENVER CO
80220-3808
US

IV. Provider business mailing address

1055 CLERMONT ST # 111L
DENVER CO
80220-3808
US

V. Phone/Fax

Practice location:
  • Phone: 303-399-8020
  • Fax:
Mailing address:
  • Phone: 303-399-8020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WI0600X
TaxonomyInfection Control Registered Nurse
License Number74659
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: