MEDICARE: KATHERINE M. RAINS FNP

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	363LF0000X	Family Nurse Practitioner	140799	MO

General Provider Information

NPI Number	:	1942319728
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHERINE M. RAINS FNP

Provider Business Mailing Address
First Line	:	PO BOX 125
Second Line	:
City	:	HERMITAGE
State	:	MO
Zip	:	65668-0125
Country	:	US
Telephone Number	:	417-745-2121
Fax Number	:	417-745-6141

Provider Business Practice Location Address
First Line	:	18614 JACKSON ST
Second Line	:
City	:	HERMITAGE
State	:	MO
Zip	:	65668
Country	:	US
Telephone Number	:	417-745-2121
Fax Number	:	417-745-6141

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

Provider Enumeration Date	:	08/29/2006
Last Update Date	:	01/09/2026

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