Healthcare Provider Details

I. General information

NPI: 1285548792
Provider Name (Legal Business Name): LUKE DANIEL RAYNOR
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 STANTONSBURG RD
GREENVILLE NC
27834-2818
US

IV. Provider business mailing address

160 MISTY HOLLOW LN
SNEADS FERRY NC
28460-6610
US

V. Phone/Fax

Practice location:
  • Phone: 252-847-4100
  • Fax:
Mailing address:
  • Phone: 910-330-9290
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146L00000X
TaxonomyParamedic
License NumberP528334
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: