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General NPI Number Information
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NPI Number | 1043624000
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Entity Type | Individual
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Provider Name | JESSICA ANNE RAINES CPNP-PC
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Gender | Female
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Dates
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Enumeration Date | 06/18/2014
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Last Update Date | 10/28/2025
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Provider Practice Location Address
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Address Line | 2220 COUNTY RD 210 W SUITE 108, #248
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City | SAINT JOHNS
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State | FL
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Zip | 32259
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Country | US
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Telephone | 904-460-3806
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Fax | 866-877-6400
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Provider Business Mailing Address
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Address Line | 2220 COUNTY RD 210 W SUITE 108, #248
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City | SAINT JOHNS
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State | FL
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Zip | 32259
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Country | US
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Telephone | 904-675-3076
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Fax | 866-877-6400
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | ARNP9215145
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License Number State | FL
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