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General NPI Number Information
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NPI Number | 1518534031
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Entity Type | Individual
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Provider Name | KIARRA RENEA GAINES RN, EMT-P
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Gender | Female
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Dates
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Enumeration Date | 06/04/2021
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Last Update Date | 06/21/2022
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Provider Practice Location Address
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Address Line | 5150 RUDGATE CIR
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City | STERLING HEIGHTS
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State | MI
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Zip | 48310-2077
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Country | US
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Telephone | 248-563-1592
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Fax |
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Provider Business Mailing Address
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Address Line | 5150 RUDGATE CIR
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City | STERLING HEIGHTS
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State | MI
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Zip | 48310-2077
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Country | US
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Telephone |
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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 | 146L00000X
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Taxonomy Name | Paramedic
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License Number | 1878908
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 4704360624
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 163WE0003X
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Taxonomy Name | Emergency Registered Nurse
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License Number | 4704360624
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License Number State | MI
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