MEDICARE: CARLY RAINS

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
1	363LA2100X	Acute Care Nurse Practitioner	RN316547	GA

General Provider Information

NPI Number	:	1457282857
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARLY RAINS

Provider Business Mailing Address
First Line	:	4837 PAYSON PL SE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30339-1977
Country	:	US
Telephone Number	:	205-451-3846
Fax Number	:

Provider Business Practice Location Address
First Line	:	4837 PAYSON PL SE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30339-1977
Country	:	US
Telephone Number	:	205-451-3846
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/26/2026
Last Update Date	:	05/26/2026

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Directions to “ CARLY RAINS ” Practice Location

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