Provider Demographics
NPI:1083426308
Name:RAINEY, JENNIFER CLAIRE BUCKNER (PA-C)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:CLAIRE BUCKNER
Last Name:RAINEY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:JENNIFER
Other - Middle Name:CLAIRE
Other - Last Name:BUCKNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 306556
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37230-6556
Mailing Address - Country:US
Mailing Address - Phone:615-329-2294
Mailing Address - Fax:615-695-1494
Practice Address - Street 1:1050 N JAMES M CAMPBELL BLVD STE 200
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:TN
Practice Address - Zip Code:38401-2754
Practice Address - Country:US
Practice Address - Phone:931-381-2663
Practice Address - Fax:931-375-0300
Is Sole Proprietor?:No
Enumeration Date:2025-01-23
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN6361363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant