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NPI Code Detail

MEDICARE: RAINA W CALDWELL

MEDICARE: RAINA W CALDWELL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial Worker15474LA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
172-1307411OTHERLATAX ID

General Provider Information

NPI Number : 1063868750
Entity Type Code : Individual
Provider Name (Legal Business Name) : RAINA W CALDWELL
Provider Business Mailing Address
First Line : 277 HARDERS CROSSING BLVD
Second Line :
City : SHREVEPORT
State : LA
Zip : 71106-8526
Country : US
Telephone Number : 318-840-7810
Fax Number :
Provider Business Practice Location Address
First Line : 277 HARDERS CROSSING BLVD
Second Line :
City : SHREVEPORT
State : LA
Zip : 71106-8526
Country : US
Telephone Number : 318-840-7810
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/11/2016
Last Update Date : 06/27/2026

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Directions to “ RAINA W CALDWELL ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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