Healthcare Provider Details

I. General information

NPI: 1902712953
Provider Name (Legal Business Name): KACI ALYSSA RAINEY MSN, RN, CEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4755 OGLETOWN STANTON RD
NEWARK DE
19718-2200
US

IV. Provider business mailing address

7 S PERCH CREEK DR
NEWARK DE
19702-3941
US

V. Phone/Fax

Practice location:
  • Phone: 302-593-8585
  • Fax:
Mailing address:
  • Phone: 302-593-8585
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberL1-0035816
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: