Healthcare Provider Details

I. General information

NPI: 1639934680
Provider Name (Legal Business Name): RACHEL RAINEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/19/2024
Last Update Date: 09/29/2024
Certification Date: 09/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

90 E 4TH ST
DUNKIRK NY
14048-2220
US

IV. Provider business mailing address

462 SYCAMORE AVE
ANGOLA NY
14006-9233
US

V. Phone/Fax

Practice location:
  • Phone: 716-785-6335
  • Fax:
Mailing address:
  • Phone: 716-844-1457
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number406040
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number820883
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: