Healthcare Provider Details

I. General information

NPI: 1083797757
Provider Name (Legal Business Name): LORI JANE RAINEY PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LORI J GEIGER

II. Dates (important events)

Enumeration Date: 10/24/2006
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 GROSSCUP AVE
DUNBAR WV
25064-3120
US

IV. Provider business mailing address

1100 GROSSCUP AVE
DUNBAR WV
25064-3120
US

V. Phone/Fax

Practice location:
  • Phone: 304-768-8811
  • Fax: 304-768-4072
Mailing address:
  • Phone: 304-768-8811
  • Fax: 304-768-4072

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number976
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: