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General NPI Number Information
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NPI Number | 1184350126
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Entity Type | Individual
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Provider Name | KAMIKA RAINEY FNP
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Gender | Female
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Dates
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Enumeration Date | 07/30/2022
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Last Update Date | 07/30/2022
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Provider Practice Location Address
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Address Line | 2121 E ARBORS DR STE 120
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City | CHARLOTTE
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State | NC
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Zip | 28262-2571
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Country | US
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Telephone | 980-288-6113
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Fax |
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Provider Business Mailing Address
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Address Line | 7124 LEESBURG RD
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City | CHARLOTTE
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State | NC
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Zip | 28215-3742
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Country | US
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Telephone | 864-356-4106
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Fax |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 5016598
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License Number State | NC
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